Fluoride in Bottled Waters Consumed in Northeastern Brazil

ABSTRACT Objective: To assess the fluoride concentration of bottled waters from municipalities in northeastern Brazil. Material and Methods: Bottled mineral waters were purchased in two periods at different commercial places of four large municipalities (João Pessoa, Campina Grande, Patos, and Cajazeiras) in the Paraíba state. The municipalities selected to present the following annual average temperature: João Pessoa 26.5 °C, Campina Grande 23.3 °C, Patos and Cajazeiras 27.5 °C. Fluoride concentration was determined using a combined ion-specific electrode. Readings (in mV) were conducted in triplicates for each standard solution and converted into fluoride concentration (mg F/L) using the Excel® software. Results: A total of 72 samples from six brands of bottled water were analyzed. The fluoride concentrations of all samples were low (0.11-0.21mg/L) but higher than those reported on the label and varied among different batches of the same brand. Conclusion: The fluoride levels in bottled water vary among brands, and these actual values are not stated in the labels.

Level of natural fluoride in public water supply: geographical and meteorological factors in Brazil's Northeast

Abstract This study analyzed the relationships between the concentration of natural fluoride in public water supply and meteorological and hydrographic factors in a northeastern region of Brazil. This was a descriptive, analytical, ecological, longitudinal, and field study conducted by collecting water in 23 municipalities (2019 to 2020) of four macroregions of Paraíba (Brazil): coast (1), borborema (2), agreste (3), and outback (4). Four collection sites were selected per municipality: two near and two distant from the water treatment plant. Fluoride concentration was determined using a combined ion-specific electrode and classified according to the Collaborating Center of the Ministry of Health in Oral Health Surveillance. Meteorological, hydrographic, and population characteristics were also collected. All analyzed samples showed natural fluoride; macroregions 2 and 4 showed the highest mean fluoride concentration, macroregion 4 presented the highest mean temperature, and all macroregions showed a similar pattern of precipitation. The mean fluoride concentration of the four macroregions was below the appropriate value to prevent caries. An increase in precipitation would decrease the fluoride concentration in water. In conclusion, the concentration of natural fluoride varied according to meteorological and hydrographic factors. The concentration in surface waters increased during periods of low precipitation. Therefore, this study provided important information to support implementation of community water fluoridation in this region.

Consensus for teaching dental caries in the Portuguese Language at Brazilian dental schools

Abstract The aim of this paper was to present a summary of the process of developing and preparing the final documents of the national consensus for teaching undergraduate Brazilian dental students the dental caries curriculum in the Portuguese language. The final document was developed in three steps: a) The ABENO and LAOHA cariology group invited experts from all five regions of Brazil to participate in the discussion. The theoretical support for crafting the first draft of the consensus was based on two publications: National Curriculum Guidelines of the Dentistry graduation in Brazil, Ministry of Education (2021) and the competences described in the European Core Curriculum for Cariology (ORCA-ADEE, 2011); b) The group of experts was divided into 5 working groups: G1-Domain, Main and Specific Competences, G2-Essential knowledge, G3-Life course perspective, G4-Social determinants and dental caries, G5- Glossary. The document was finalized by thoroughly reviewing the process using Delphi methodology; c) The 5-chapter document (one from each working group) was submitted to three open public consultations in 2022 (May-June, August, and October) using Google-forms. The suggestions (content/wording) were discussed within the group as: totally accepted, partially accepted, and rejected. A total of 192 suggestions were registered from 31 dental schools in all regions of Brazil. The number of suggestions received per Group were: 84, 28, 26, 24, 30 suggestions for G1, G2, G3, G4 and G5, respectively. The majority of suggestions were totally accepted by the group of experts (n = 172, 89.6%), 15 were partially accepted (7.8%), and 5 were rejected. Conclusion The final document could be considered to be the first national consensus for teaching the dental caries curriculum in Brazil.

Impact of the first thousand days of life on dental caries through the life course: a transdisciplinary approach

Abstract This review aimed to describe the importance of the first 1000 days of a child's life as a golden period for interventions and actions to prevent dental caries and other chronic non-communicable diseases (NCDs) throughout the life course and highlight that the first 450 days of life could be even more important for oral health. During the first 1000 days of life (pregnancy and first two years of life), health care providers can identify unhealthy lifestyles, behaviors, and their determinants. Bearing in mind contextual factors like socioeconomic conditions and cultural aspects, this is a unique period to work together with the family and identify opportunities for adopting healthy habits that might last throughout the life of the expected or newborn child. This is a "window of opportunity" for the prevention of chronic NCDs of both systemic and oral origin, such as overweight, obesity, diabetes, cardiovascular diseases, and dental caries. In fact, to effectively prevent dental caries, pregnancy and the first 6 months of a child's life (first 450 days) should be considered the critical period to work together with families to facilitate the adoption of healthy habits. Knowledge about the first thousand days of life is essential and represents a crucial period for the implementation of actions and interventions that will guarantee good oral and general health development that can persist throughout life.

Effect of dentifrices with different pH and fluoride concentrations on fluoride levels in biofilm and nails: an RCT

Abstract: Purpose: to evaluate the effect of dentifrice pH and fluoride concentration ([F]) on fluoride uptake on the biofilm and nails of children from a non-fluoridated area. Methods: two hundred and twenty-eight two- to four-year-old children were randomly allocated into 3 groups according to the type of dentifrice: G1: 1100 μg F/g, pH 4.5 (n = 76); G2: 750 μg F/g, pH 4.5 (n = 74); and G3: 1100 μg F/g, pH 7.0 (n = 78). Nails were collected at 4, 8, and 12 months after starting dentifrice use and biofilm was collected 5 and 60 minutes after toothbrushing. The concentrations of F in nails and biofilm were analyzed by HMDS facilitated diffusion. Data were analyzed by Kruskal-Wallis/Mann-Whitney's test and the comparison between biofilm collection times was done using Wilcoxon test (p £ 0.05). Results: a significant reduction of [F] in biofilm was observed 60 minutes after toothbrushing, regardless of the dentifrice used. However, 5 minutes after toothbrushing, G1 had a significantly higher [F] compared to G2 and G3, and 60 minutes after toothbrushing, [F] was significantly higher for G1 and G2 compared to G3. G1 and G3 had significantly higher [F] in the nails compared to G2. Conclusion: a lower dentifrice concentration is a relevant factor for the reduction of excessive fluoride intake. The use of a low-F acidified dentifrice combines the reduction of fluoride uptake with caries prevention by leading to greater incorporation of F into the biofilm over time.

Dental caries prevalence, prospects, and challenges for Latin America and Caribbean countries: a summary and final recommendations from a Regional Consensus

Abstract Dental caries can be effectively managed and prevented from developing into cavitated lesions while preserving tooth structure at all levels. However, the strong correlation between caries and socioeconomic factors may compromise the efficacy of preventive strategies. The high prevalence of persistent inequalities in dental caries in Latin American and Caribbean countries (LACC) is a matter of concern. The estimates of the burden of disease in some countries in this region are outdated or absent. This paper aims to summarize and present the final recommendations of a regional Consensus for Dental Caries Prevalence, Prospects, and Challenges for LACC. This consensus is based on four articles that were written by a team of Latin American experts, reviewed by dental associations, and presented and discussed in two consensus events. The following domains were explored: epidemiology, risk factors, prevention strategies, and management of dental caries with a focus on restorative procedures. Dental caries can manifest throughout the lifespan of an individual, making it a matter of concern for infants, children, adults, and older people alike. The prevalence rates of untreated caries in deciduous and permanent teeth are high in many parts of the world, including LACCs. Previous evidence suggests that the prevalence of dental caries in 12-year-olds is moderate to high in most Latin American countries. Moreover, the prevalence of treatment needs and dental caries in the adult and elderly population can also be regarded as high in this region. The risk/protective factors (e.g., sugar consumption, exposure to fluoride, and oral hygiene) probably operate similarly in all LACCs, although variations in the interplay of these factors in some countries and within the same country cannot be ruled out. Although salt and water fluoridation programs are implemented in many countries, there is a need for implementation of a surveillance policy. There is also room for improvement with regard to the introduction of minimal intervention techniques in practice and public health programs. Dental caries is a marker of social disadvantage, and oral health promotion programs and interventions aimed at reducing the burden of dental caries in LACCs must consider the complexity of the socioeconomic dynamics in this region. There is an urgent need to promote engagement of stakeholders, policymakers, medical personnel, universities, dental associations, community members, and industries to develop regional plans that enhance the oral health agenda for LACCs. A list of recommendations has been presented to underpin strategies aimed at reducing the prevalence and severity of dental caries and improving the quality of life of the impacted LACC population in the near future.

Layered double hydroxides for controlled fluoride release

Abstract This study aims to develop a nano-sized fluoridated layered double hydroxide (LDH)-based release system via hydrothermal treatment for the controlled delivery of fluoride (F-) ions in the oral environment. The synthesis of conventional LDH-type (C-LDH) precursor nanomaterials was conducted using a co-precipitation method at constant pH, and the nanoparticulate-LDH (N-LDH) was synthesized by a hydrothermal procedure. Fluoride LDH (F-LDH) products were obtained through indirect synthesis using the precursor ion-exchange technique by varying the agitation time (2 and 24 h) and temperature (25 and 40 °C) to produce 12 material samples. The materials were characterized by energy dispersive x-ray, hexamethyldisilazane, digital radiography x-ray, Fourier-transform infrared, thermogravimetric analysis, and scanning electron microscopy. Additionally, the F-release kinetic profile was evaluated for 21 d in neutral and acid media with mathematical model analysis. Products with varying F-quantities were obtained, revealing specific release profiles. In general, there was a higher F-release in the acid medium, with emphasis on F-LDH-8. Fluoride-LDH and controlled fluoride delivery was successfully obtained, proving the potential of these nanomaterials as alternative anti-caries agents.

External control of water fluoridation in a small municipality of northeast of Brazil / Heterocontrole da fluoretação das águas em um município de pequeno porte no nordeste do Brasil

Abstract Introduction Fluoridation of public water supply is an important measure in the prevention of dental caries. Objective This study aimed to monitor the fluoride (F) concentrations of a public water supply with water fluoridation program in a small municipality in the Northeast region of Brazil. Material and method It is a quantitative study with a descriptive approach. Three points of the urban area were selected for collecting water samples twice a month for 12 months. The average of F concentrations was calculated considering these three samples of each collection point at the same occasion. F concentrations in the water samples were determined by potentiometry and the results were classified according to the criterion proposed by criterion set down by Collaborating Center of the Brazilian Ministry of Health for Oral Health Surveillance. The samples were classified according to the best risk-benefit adjustment (0.55 - 0.84 mg F /L). Result Less than 10% of the samples were within the ideal range. Conclusion It was observed that water fluoridation in this municipality was interrupted since many water samples showed f-levels below the minimal acceptable values.

Resumo Introdução A fluoretação das águas de abastecimento público é uma medida importante na prevenção à cárie dentária. Objetivo O objetivo do presente estudo foi avaliar e monitorar os teores de flúor nas águas de abastecimento público em um município de pequeno porte no Nordeste do Brasil. Material e método O estudo apresenta uma abordagem quantitativa de caráter descritivo. Foram selecionados 3 pontos para realizar coleta das águas duas vezes no mês na zona urbana do município durante 12 meses. A concentração de flúor foi obtida pela média das três leituras das amostras analisadas para cada ponto de coleta e classificadas conforme critério proposto pelo Centro Colaborador do Ministério da Saúde em Vigilância da Saúde Bucal. Resultado Segundo o critério utilizado (0,55 - 0,84 mg/L F), apenas 9,7% das amostras estavam dentro do considerado ideal. Conclusão Observou-se que a fluoretação das águas nesse município foi interrompida, pois muitas amostras de água apresentaram níveis de flúor abaixo dos valores mínimos aceitáveis.

Investigation of the Erosive Potential of Different Types of Alcoholic Beverages

Abstract Objective: To evaluate the erosive potential of different alcoholic beverages according to pH, titratable acidity and buffering capacity. Material and Methods: Thirteen industrialized alcoholic beverages of different brands were selected and divided into five groups according to their type and composition. The pH measurement and titratable acidity for pH 5.5 and 7.0 were performed in triplicate in 50 mL of each beverage. The buffering capacity was calculated based on pH and titratable acidity for pH 7.0. ANOVA, Tukey, and Pearson correlation, with p<0.05, were used for data analysis. Results: Data showed normal distribution by Shapiro-Wilk test. The pH of alcoholic beverages ranged from 2.49 (Miks Ice Tea - Green Fruits) to 7.64 (Smirnoff). The highest values of acid titration (4.68) and buffer capacity (19.97) were observed in Smirnoff Ice. The following correlations (p<0.01) were noted between: pH and titratable acidity; buffering capacity and pH; buffering capacity and titratable acidity. Conclusion: Some beers and alcopops presented erosive potential due to their lower pH associated with high acid titration values. The whisky and sugarcane liquor examined were not potentially erosive.

Análise de espécies bacterianas em telefones públicos do centro da cidade de Caruaru ­ PE / Analysis of bacterial species in public telephones in the city center of Caruaru ­ PE

Introdução: os aparelhos de telefones públicos representam importantes agentes disseminadores de infecções por se tratarem de objetos frequentemente manipulados por grande número de pessoas em trânsito das mais diversas regiões. Considerando que a pele humana contém uma microbiota típica e a manipulação de objetos pode propiciar o deslocamento de microrganismos, os aparelhos de telefone podem transmitir doenças através desses agentes. Objetivo: analisar a variedade de espécies bacterianas nos fones de ouvido dos aparelhos de telefones públicos localizados no centro da cidade de Caruaru-PE (Brasil). Metodologia: foram coletados esfregaços dos fones de ouvido, especificamente da região auricular, de 77 telefones públicos do centro da cidade de Caruaru. O material foi colhido com swab estéril e transportado em meio BHI ao Laboratório de Práticas da Saúde da Associação Caruaruense de Ensino Superior, onde foram realizadas cultura e identificação dos agentes bacterianos. Resultados: em todas as amostras foram encontradas bactérias, havendo um predomínio de Staphylococcus coagulase negativa (50,64%), seguido de Bacillus subtilis (27,27%), como também houve presença de Bacillus sp. (28,57), Staphylococcus aureus (18,18%), Enterococcus sp. (2,59), Streptococus do grupo viridans (1,29) e Streptococus sp. (1,29). Conclusão: Há grande diversidade de espécies bacterianas nos fones de ouvido dos telefones públicos do Centro de Caruaru.

Introduction: public telephones represent important dissemination agents because they are objects varied by large numbers of people in transit from the most diverse regions. Consider that a human skin contains a typical microbiota and a manipulation of objects can propitiate the displacement of microorganisms, telephone devices can transmit diseases through agents. Objective: To analyze a variety of bacterial species in the headsets of public telephone sets located in the city of Caruaru-PE (Brazil). Methods: Smears were collected from the earphones, specifically from the auricular region, from 77 public telephones in the city center of Caruaru. The material was collected with sterile swab and transported in BHI medium to the Laboratory of Health Practices of the Caruaruense Association of Higher Education, where culture and identification of bacterial agents were carried out. Results: Staphylococcus coagulase negative (50.64%), followed by Bacillus subtilis (27.27%), were also found in all samples, as well as the presence of Bacillus sp. (28,57), taphylococcus aureus (18.18%), Enterococcus sp. (2,59), Streptococus do grupo viridans (1,29) and Streptococus sp. (1,29). Conclusion: There is a great diversity of bacterial species in the headsets of the public telephones of the Center of Caruaru.

Dental fluorosis treatment can improve the individuals' ohrqol? results from a randomized clinical trial

Abstract This study aimed to evaluate the effect on oral health-related quality of life (OHRQoL) of two treatment protocols for dental fluorosis in individuals enrolled in a randomized clinical trial. Seventy volunteers, who lived in a fluorosis endemic area in Brazil, and had at least four maxillary anterior teeth showing fluorosis with a Thylstrup and Fejerskov index from 1 to 7, were randomized into two treatment groups (n= 35): GI- enamel microabrasion; or GII- microabrasion associated with at-home bleaching. Microabrasion was performed using 37% phosphoric acid and pumice, and at-home tooth bleaching with 10% carbamide peroxide in a tray. Volunteers completed a questionnaire at baseline and 1-month post treatment to assess changes in OHRQoL, using the Oral Impact on Daily Performance (OIDP). Differences in overall impact scores between and within treatment groups were analyzed with Wilcoxon (within) and Mann-Whitney (between) tests. Changes in performance scores were analyzed using Wilcoxon tests (a< 0.05). One month after treatment, subjects reported improvement in OHRQoL. Both groups showed lower OIDP scores (p< 0.001), but there was no difference between them. Eating, cleaning teeth, smiling and emotional state performance scores were lower after treatment for the whole sample. In conclusion, the treatment with microabrasion improved the OHRQoL in this sample of individuals living in a fluorosis endemic area regardless of the addition of at-home bleaching.

Resumo Este estudo teve como objetivo avaliar o efeito na qualidade de vida relacionada à saúde bucal (QVRSB) de dois protocolos de tratamento para fluorose dentária, em indivíduos incluídos em um ensaio clínico randomizado. Setenta voluntários, os quais viviam em uma área de fluorose endêmica no Brasil, e que possuíam pelo menos quatro dentes ântero-superiores com índice de Thylstrup e Fejerskov de 1 a 7, foram randomizados em dois grupos de tratamento (n= 35): GI- microabrasão de esmalte; ou GII- microabrasão associada com clareamento caseiro. A microabrasão foi realizada com ácido fosfórico 37% e pedra pomes e, o clareamento caseiro com peróxido de carbamida 10% e uso de moldeira. Os voluntários responderam um questionário antes e 1 mês após o tratamento, visando avaliar mudanças na QVRSB através do instrumento Oral Impact on Daily Performance (OIDP). Diferenças nos escores de impacto geral entre e nos mesmos grupos de tratamento foram analisadas através dos testes Wilcoxon (mesmo grupo) e Mann-Whitney (entre grupos), respectivamente. Alterações no escores dos domínios foram analisadas usando o teste Wilcoxon (a<0.05). Um mês após o tratamento, os indivíduos relataram melhora na QVRSB. Ambos os grupos apresentaram menores escores do OIDP (p<0,001), sem diferença entre eles. Os escores dos domínios comer, limpar os dentes, sorrir e estado emocioal diminuíram após o tratamento para toda a amostra. Concluiu-se que o tratamento com microabrasão melhorou a QVRSB de indivíduos vivendo em uma área de fluorose endêmica independentemente da associação com o clareamento caseiro.

Erosive Potential of Industrialized Teas: An in vitro study

Objective: To evaluate the erosive potential of manufactured teas according to pH, titratable acidity and buffering capacity. Material and Methods: Eight types of manufactured teas of different brands and flavors acquired in supermarkets of João Pessoa, Brazil, were investigated. Indaiá® mineral water and Coca-Cola® were controls. The pH measurement and titratable acidity for pH 5.5 and 7.0 were performed in triplicate in 50 ml of each beverage. The buffering capacity was calculated based on pH and titratable acidity for pH 7.0. ANOVA, Tukey, and Pearson correlation, with p <0.05, were used for data analysis. Results: Data showed normal distribution by Kolmogorov-Smirnov test for all variables. There was a statistically significant relationship between groups analyzed in all variables (ANOVA, p <0.001). The pH of teas ranged from 2.70 (Black Tea with lemon-Leão Fuze®) to 4.03 (Natural Mate Tea - Matte Leão®). The following significant correlations (p <0.01) were observed: pH and titratable acidity; buffering capacity and pH; buffering capacity and titratable acidity. Conclusion: All teas analyzed were potentially erosive; however, Black Tea with lemon (Leão Fuze®) had the lowest pH, the highest titratable acidity and buffering capacity, demonstrating that the saliva will have greater difficulty in buffering this tea in the oral environment.

Habituation of enterotoxigenic Staphylococcus aureus to Origanum vulgare L. essential oil does not induce direct-tolerance and cross-tolerance to salts and organic acids

Enterotoxigenic Staphylococcus aureus strains that were isolated from foods were investigated for their ability to develop direct-tolerance and cross-tolerance to sodium chloride (NaCl), potassium chloride (KCl), lactic acid (LA) and acetic acid (AA) after habituation in sublethal amounts (1/2 of the minimum inhibitory concentration - 1/2 MIC and 1/4 of the minimum inhibitory concentration - 1/4 MIC) of Origanum vulgare L. essential oil (OVEO). The habituation of S. aureus to 1/2 MIC and 1/4 MIC of OVEO did not induce direct-tolerance or cross-tolerance in the tested strains, as assessed by modulation of MIC values. Otherwise, exposing the strains to OVEO at sublethal concentrations maintained or increased the sensitivity of the cells to the tested stressing agents because the MIC values of OVEO, NaCl, KCl, LA and AA against the cells that were previously habituated to OVEO remained the same or decreased when compared with non-habituated cells. These data indicate that OVEO does not have an inductive effect on the acquisition of direct-tolerance or cross-tolerance in the tested enterotoxigenic strains of S. aureus to antimicrobial agents that are typically used in food preservation.

Evaluation of acidulated dentifrice influence on fluoride releasing from glass-ionomer cements / Avaliação da influência de creme dental acidulado na liberação de flúor de cimentos de ionômero de vidro

Objetivo: Avaliar a influência da exposição a um creme dental acidulado sobre a liberação de flúorde Cimentos de Ionômero de Vidro (CIV). Material e Métodos: Confeccionou-se 27 corpos de prova divididos em 3 grupos: G1 (Maxion - R), G2 (KetacMolar 3M/ESPE) e G3 (Vittremer 3M/ESPE), subdividido em subgrupos (n = 3): A (exposição ao creme dental flúor acidulado – pH 4,5 / 7 h / 37ºC), B (exposição ao creme dental fluoretado não acidulado / 7 h / 37 ºC) e C (controle - exposição à saliva artificial). Após exposição aos cremes dentais,os corpos de prova foram imersos em saliva artificial e aferidas a liberação de flúor nos períodos de tempo:1 e 14 dias. Os dados obtidos foram submetidos a análise de variância, utilizando o pacote SPSS (Statiscal Package for Social Science). Aplicou-se seo Teste ANOVA com 5% de probabilidade, para comparação das médias e do comportamento de cada material. Resultados: A exposição ao creme dental ácido apresentou valores de liberação de flúor (ppm/mm2) que variaram, em suas médias, de 1 e 14 dias:G1A (0,269 a 0,204); G2A (0,394 a 0,038); G3A(0,080 a 0,123). Foi estatisticamente significante a relação entre os subgrupos para G1 em T1 e G3 emT1 e T14. Conclusão: a exposição ao creme dental acidulado influenciou positivamente a liberação de flúor do CIV híbrido testado e não impactou a liberação deste íon nos CIVs convencionais.

Objectives: To evaluate the acidulated dentifrice influence on fluoride releasing from glass-ionomercements. Methods: 27 specimens were constructed,divided into 3 groups: G1 (Maxion - R), G2 (KetacMolar 3M/ESPE) and G3 (Vittremer 3M/ESPE), and subdivided into 3 subgroups (n = 3): A (exposure to acidulated fluoride dentifrice – pH 4.5 / 7h /37 ºC), B (exposure to non-acidulated fluoridedentifrice / 7h / 37 ºC), C (control - exposure toartificial saliva). After exposing, the specimens were immersed into artificial saliva and the fluoridere leasing measured at the following time periods:1 to 14 days. Data were subjected to analysis ofvariance using the Statistical Package for Social Science (SPSS). ANOVA test was applied with levelof significance of 5% to compare the means and the behavior of each material. Results: The exposure to acidulated dentifrice showed fluoride releasing means values (ppm/mm2) that varied from 1 and 14days : G1A (0.269 to 0.204); G2A (0.394 to 0.038);G3A (0.080 to 0.123). The relationship among the G1 subgroups at T1 and G3 subgroups at T1and T14 was statistically significant. Conclusion:The acidulated dentifrice positively influenced onfluoride releasing of hybrid GIC but not on that ofconventional GICs.

Fluoride varnishes with calcium glycerophosphate: fluoride release and effect on in vitro enamel demineralization

The aims of this study were (1) to assess the amount of fluoride (F) released from varnishes containing calcium glycerophosphate (CaGP) and (2) to assess the effect of the experimental varnishes on in vitrodemineralization. Six test groups using 5 varnishes: base varnish (no active ingredients); Duraphat® (2.26% NaF); Duofluorid® (5.63% NaF/CaF2); experimental varnish 1 (1% CaGP/5.63% NaF/CaF2); experimental varnish 2 (5% CaGP/5.63% NaF/CaF2); and no varnish were set up. In stage 1, 60 acrylic blocks were randomly distributed into 6 groups (n = 10). Then 300 µg of each varnish was applied to each block. The blocks were immersed in deionized water, which was changed after 1, 8, 12, 24, 48 and 72 hours. Fluoride concentration in the water was analyzed using a fluoride electrode. In stage 2, 60 bovine enamel samples were distributed into 6 groups (n = 10), and treated with 300 µg of the respective varnish. After 6 h the varnish was removed and the samples were subjected to a 7-day in vitro pH cycle (6 h demineralization/18 h remineralization per day). The demineralization was measured using surface hardness. The results showed that both experimental varnishes released more fluoride than Duofluorid® and Duraphat® (p < 0.05), but Duraphat® showed the best preventive effect by decreasing enamel hardness loss (p < 0.05). Therefore, we conclude that even though (1) the experimental varnishes containing CaGP released greater amounts of F, (2) they did not increase in the preventive effect against enamel demineralization.

External control over fluoridation of the public water supply in São Luís, MA, Brazil

Objective:To tomonitor fluoride concentrations in the public water supply of São Luís, Maranhão, Brazil, from February 2008 to January 2009. Material and Method:Forty sampling points representing 39 neighborhoods of São Luís were conveniently selected. The points were selected based on the sites where the public water supply is provided by the local water supply company and also considering the proximity of elevated water reservoir tanks. The analysis of the fluoride concentration was performed in triplicate using an ion-specific electrode for fluoride connected to a previously calibrated potentiometer. After analysis, the samples were considered adequate when the fluoride concentration was within recommended limits from 0.60 up to 0.80 ppm F (criterion I) or within the stipulated range from 0.55 ppm up to 0.84 ppm F (criterion II). Results:The results showed a large variation between minimum and maximum concentrations. Considering all samples, the average values (± SD) for the municipality was 0.58 ppm F (± 0.24) and median value was 0.61 ppm F, with minimum and maximum value of 0.02 and 1.33 ppm F, respectively. Of the 480 samples, 62.9% was considered inadequate by criterion I, while using criterion II, the percentage was 48.3%. Conclusion:The fluoridation program in São Luís-MA needs improvement. Therefore, surveillance based on external control and operational control becomes essential to ensure that the method is efficient and effective

Cell Viability of Candida albicans Against the Antifungal Activity of Thymol

Candida albicans is a commensal fungus, but circumstantially it may cause superficial infections of the mucous membranes, such as denture stomatitis, when a biofilm is formed on the surface of dental prostheses. This study evaluated the cell viability of C. albicans biofilms against the antifungal activity of thymol when compared with miconazole, by the fluorescence imaging using SYTO 9 and propidium iodide dyes, and counting of colony forming units. C. albicans standard strains (ATCC 11006) were used. The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of drugs were determined by broth microdilution tests and the inoculum was standardized to match 0.5 on the McFarland scale (106 cfu/mL). Biofilms were grown on the surface of acrylic resin disks in parallel flow chambers from Sabouraud broth supplemented with 10% dextrose. For counting of colony forming units, the fungal solution was sequentially diluted and plated in Sabouraud dextrose agar. Data were analyzed using two-way ANOVA and Tukey's test (a=5%). Biofilms treated with thymol and miconazole presented low numbers of viable cells at the evaluated exposure times. There was statistically significant difference (p<0.05) when compared with control, and the mean value of the exposure times between miconazole and thymol did not differ significantly (p>0.05). In conclusion, both drugs have similar efficiency as antifungal agents against biofilms of C. albicans formed on acrylic surfaces.

Candida albicans é um fungo comensal que circunstancialmente pode causar infecções superficiais das mucosas, como a estomatite protética, na qual o biofilme se forma sobre a superfície das próteses dentárias. Este estudo avaliou a viabilidade celular de biofilmes de C. albicans frente à ação antifúngica do timol em comparação com o miconazol por meio da técnica de fluorescência, empregando os corantes SYTO 9 e iodeto de propídio, e contagem das unidades formadoras de colônia. Utilizaram-se cepas de C. albicans (ATCC 11006). As concentrações inibitórias mínimas (CIM) e fungicidas mínimas (CFM) das drogas foram determinadas com testes de microdiluição em caldo, sendo o inóculo padronizado para corresponder a 0,5 da escala de McFarland (106 UFC/mL). Os biofilmes foram cultivados sobre a superfície de discos de resina acrílica, em células paralelas de fluxo, a partir de caldo Sabouraud suplementado com dextrose 10%. Para a contagem das unidades formadoras de colônia, as soluções fúngicas foram sequencialmente diluídas e semeadas em agar Sabouraud dextrose Os dados foram analisados por meio de estatística ANOVA A dois fatores e teste de Tukey (α = 5%). Biofilmes tratados com o timol e miconazol apresentaram baixos números percentuais de células viáveis nos tempos de exposição avaliados. Houve diferença estatística significante (p<0.05) em comparação com o controle, e o valor médio dos tempos de exposição entre miconazol e timol não diferiu estatisticamente (p>0.05). Concluindo, ambas as drogas possuem similar eficiência como agentes antifúngicos contra a viabilidade de biofilmes de C. albicans formados em superfícies de resinas acrílicas.

Reflexoes metodologicas sobre prevalencia da fluorose dentaria nos inqueritos de saude bucal / Reflexiones metodologicas sobre prevalencia de fluorosis dentaria en las pesquisas de salud bucal / Methodological discussion about prevalence of the dental fluorosis on dental health surveys

OBJETIVO: Analisar limitações do estudo de fluorose dentária em inquéritos transversais. MÉTODOS: Foram utilizados dados dos estudos Condições de Saúde Bucal da População Brasileira (SBBrasil 2003) e da Pesquisa Nacional de Saúde Bucal (SBBrasil 2010). A estimativa de tendência epidemiológica da fluorose na população de 12 anos, aspectos da confiabilidade dos dados, bem como a precisão das estimativas, foram avaliadas nessas duas pesquisas. A distribuição da prevalência de fluorose foi feita segundo os domínios de estudo (capitais e regiões) e o ano estudado. Foram expressos também os intervalos de confiança (IC95%) para a prevalência simples (sem considerar os estágios de gravidade). RESULTADOS: A prevalência da fluorose dentária apresentou uma variação considerável, de 0% a 61% em 2003 e de 0% e 59% em 2010. Foram observadas inconsistências nos dados em termos individuais (por ano e por domínio) e no comportamento da tendência. Considerando a expectativa de prevalência e os dados disponíveis nas duas pesquisas, o tamanho mínimo da amostra deveria ser de 1.500 indivíduos para se obterem intervalos de 3,4% e 6,6% de confiança, considerando um coeficiente de variação mínimo de 15%. Dada a subjetividade na natureza de sua classificação, exames de fluorose dentária podem apresentar mais variação do que aqueles realizados para outras condições de saúde bucal. O poder para estabelecer diferenças entre os domínios do estudo com a amostra do SBBrasil 2010 é bastante limitado. CONCLUSÕES: Não foi possível analisar a tendência da fluorose dentária no Brasil com base nos estudos de 2003 e 2010; esses dados são apenas indicadores exploratórios da p...

OBJETIVO: Analizar limitaciones del estudio de fluorosis dentaria en pesquisas transversales. MÉTODOS: Se utilizaron datos de estudios de de Condiciones de Salud Bucal de la Población Brasileña (SBBrasil 2003) y de la Investigación Nacional de la Salud Bucal (SBBrasil 2010). La estimativa de tendencia epidemiológica de la fluorosis en la población de 12 años, aspectos de la confiabilidad de los datos, así como la precisión de las estimativas, fueron evaluadas en estas dos investigaciones. La distribución de la prevalencia de la fluorosis fue hecha de acuerdo con los dominios de estudio (capitales y regiones) y el año estudiado. Se expresaron también los intervalos de confianza (IC95%) para la prevalencia simple (sin considerar las fases de la gravedad). RESULTADOS: La prevalencia de la fluorosis dentaria presentó una variación considerable, de 0 a 61% en 2003 y de 0 a 59% en 2010. Se observaron inconsistencias en los datos en términos individuales (por año y por dominio) y en el comportamiento de la tendencia. Considerando la expectativa de prevalencia y los datos disponibles en las dos investigaciones, el tamaño mínimo de la muestra debería ser de 1.500 individuos para obtener intervalos de 3,4% y 6,6% de confianza, considerando un coeficiente de variación mínimo de 15%. Dada la subjetividad en la naturaleza de su clasificación, exámenes de fluorosis dentaria pueden presentar más variación de los realizados para otras condiciones de salud bucal. El poder para establecer diferencias entre los dominios del estudio con la muestra de SBBrasil 2010 es bastante limitado. CONCLUSIONES: No fue posible analizar la tendencia de la fluorosis dentaria en Brasil con base en los estudios de 2003 y 2010; esos datos son sólo indicadores exploratorios de la prevalencia de la fluorosis. La comparación se hace imposible ...

OBJECTIVE: To evaluate the influence of social inequalities of individual and contextual nature on untreated dental caries in Brazilian children. METHODS: The data on the prevalence of dental caries were obtained from the Brazilian Oral Health Survey (SBBrasil 2010) Project, an epidemiological survey of oral health with a representative sample for the country and each of the geographical micro-regions. Children aged five (n = 7,217) in 177 municipalities were examined and their parents/guardians completed a questionnaire. Contextual characteristics referring to the municipalities in 2010 (mean income, fluorodized water and proportion of residences with water supply) were supplied by the Brazilian Institute of Geography and Statistics – Fundação Instituto Brasileiro de Geografia e Estatística . Multilevel Poisson regression analysis models were used to assess associations. RESULTS: The prevalence of non-treated dental caries was 48.2%; more than half of the sample had at least one deciduous tooth affected by dental caries. The index of dental caries in deciduous teeth was 2.41, with higher figures in the North and North East. Black and brown children and those from lower income families had a higher prevalence of untreated dental caries. With regards context, the mean income in the municipality and the addition of fluoride to the water supply were inversely associated with the prevalence of the outcome. CONCLUSIONS: Inequalities in the prevalence of untreated dental caries remain, affecting deciduous teeth of children in Brazil. Planning public policies to promote oral health should consider the effect of contextual factors as a determinant of individual risk. .