Relación entre el índice CPOD y la limitación para socializar en escolares de Ecuador / Relationship between the DMFT index and the limitation to socialize in schoolchildren from Ecuador

Introducción: La Organización Mundial de la Salud define a la caries dental como un problema de salud mundial que afecta entre el 60 al 90% de la población. Se considera una enfermedad transmisible de origen multifactorial, que evoluciona de manera progresiva hasta ocasionar la destrucción de los tejidos duros. Objetivo: Determinar la relación entre dientes cariados, perdidos y obturados, y la limitación para socializar en escolares de Ecuador. Métodos: Se realizó un estudio descriptivo de tipo correlacional sobre una población de 154 escolares de 12 años de la parroquia el Batán, de Cuenca-Ecuador (2016); para el análisis estadístico los datos fueron ingresados al programa SPSS, donde se efectuó estadística descriptiva para cada una de las variables y la limitación para socializar. Resultados: Se logró constatar que la población objeto presentó un índice de CPOD muy bajo (32,5 %), de igual forma se evidenció que el 62,7% no presentó limitación a la hora de socializar. En cuanto a la correlación entre ambas variables, se mostró una asociación positiva con un nivel de significancia de p=0,002. Una de las principales limitaciones del estudio fue el escaso contacto con los participantes. Se recomienda, efectuar investigaciones epidemiológicas longitudinales con la finalidad de observar la variación del coeficiente de correlación de las variables en fases de pretratamiento y de postratamiento. Conclusión: Al finalizar el estudio, se demostró que existe correlación estadística entre el índice CPOD y la limitación en el desempeño socializar en los escolares de 12 años de la parroquia el Batán.

Introduction: the World Health Organization defines dental caries as a global health problem that affects between 60 and 90% of the population. It is considered a communicable disease of multifactorial origin, which evolves progressively until it causes the destruction of hard tissues. Objective: to determine the relationship between decayed, missing and filled teeth and the limitation to socialize in schoolchildren from Ecuador. Methods: a descriptive correlational study was carried out on a population of 154 schoolchildren aged 12 years from the El Batán parish, Cuenca-Ecuador (2016); data was entered into the SPSS program for the statistical analysis, where descriptive statistics were performed for each of the variables and for the limitation to socialize. Results: it was possible to verify that the target population had a very low DMFT index (32.5%); in the same way it was evidenced that 62.7% did not have limitations when socializing. A positive association, with a significance level of p=0.002, was shown regarding the correlation between both variables. One of the main limitations of the study was the limited contact with the participants. We recommend to carry out longitudinal epidemiological investigations in order to observe the variation of the correlation coefficient of the variables in the pre-treatment and post-treatment phases. Conclusion: we showed, at the end of the study, that there is a statistical correlation between the DMFT index and the limitation in socializing performance in 12-year-old schoolchildren from the El Batán parish.

Effectiveness of comprehensive intervention on primary dental caries in 3-year-old children in Bengbu / 中国学校卫生

Objective@#To explore the effectiveness of the comprehensive intervention on prevention of deciduous primary caries in 3-year-old children, so as so provide reference for the prevention, health care and treatment of oral caries.@*Methods@#Three-year-old children selected by drawing lots from 10 public kindergartens in 5 districts of Bengbu were examined in 2021, and were randomly divided into intervention group ( n =300) and control group ( n =300). During the initial examination, caries loss (dmf) including dental caries, missing teeth, filling teeth were assessed in the two groups. At the initial examination, the intervention group received caries intervention while no intervention was administered in the non-intervention group until half a year later. Intervention measures included education, diet, self-cleaning and fluoride application intervention. The number of cases and the mean of caries loss in the two groups were compared by χ 2 test.@*Results@#Before the intervention, 43 children in the control group suffered from caries, with 88 dmf, including 44 dmf for boys and 44 dmf for girls. There were 45 children in the intervention group, with 101 dmf, including 49 dmf for boys and 52 dmf for girls. There was no significant difference in the number of dmf between the intervention group and the control group ( χ 2=0.91, P >0.05), and there was no significant difference in the prevalence rate (15.0%, 14.3%, χ 2=0.05, P >0.05). After the intervention, there were 26 new dental caries and 43 dmf in intervention group, including 25 dmf for boys and 18 dmf for girls. In the control group, there were 83 new dental caries and 168 dmf, including 72 dmf for boys and 96 dmf for girls. Compared with the control group, the new dmf in the intervention group was significantly different ( χ 2=75.38, P < 0.05). The number of new dental caries patients in the intervention group was significantly different from that in the control group ( χ 2=36.42, P <0.05).@*Conclusion@#Comprehensive interventions to prevent dental caries can significantly reduce the incidence of primary teeth caries in children. It is suggested to intervene dental caries as early as possible to reduce the incidence of dental caries and other oral diseases.

Políticas Públicas Odontológicas y su Relación con Historial de Caries en Menores Controlados en Atención Pública de Chile (2008-2017)

RESUMEN: Las enfermedades que afectan la salud bucodental en Chile son de alta prevalencia, severidad y afectan la calidad de vida de las personas. El Estado chileno ha implementado políticas públicas destinadas a mejorar la salud bucodent al, que benefician principalmente a niños y embarazadas. El trabajo consistió en un estudio observacional analítico. Se analizaron los índices COPD y ceod de las edades: 2, 4, 6 y 12 años, obtenidos de los Registros Estadísticos Mensuales (REM) de los años 2008-2017 (n=3.415.720). Análisis de datos: Excel 2011, EPIDAT 4.2 y SPSS; pruebas de Chi cuadrado y T-student (IC 95% y p<0,05). Disminución en prevalencia y severidad de caries durante los 10 años en estudio (p <0,05). Disminución estadísticamente significativa en la prevalencia y severidad de caries posterior a la implementación del programa que beneficia a los niños de 6 años. En cuanto a los programas Salud Oral Integral para la embarazada y Sembrando Sonrisas, solo tuvieron una disminución estadísticamente significativa en la severidad de caries. Se pudo observar impacto positivo de todas las políticas públicas estudiadas principalmente en la severidad de caries a lo largo de los años en estudio. No se pueden hacer comparaciones estadísticas con estudios previos por presentar metodologías muy disimiles con el presente. Se debe destacar la relevancia de un correcto registro de los índices en el REM. Es necesario realizar vigilancia epidemiológica según las metodologías y tiempos indicados para evaluar que papel ha jugado la prevención y promoción planteada en los objetivos estratégicos de la década que recién terminó.

ABSTRACT: Diseases affecting oral health in Chile are highly prevalent, severe and affect people's quality of life. The Chilean State has implemented public policies aimed at improving oral health, mainly benefiting children and pregnant women. This was an analytical observational study. DMF index for primary and permanent theeth were analyzed for ages: 2, 4, 6 and 12 years, obtained from the Monthly Statistical Records (MSR) for the years 2008-2017 (n=3.415.720). Data analysis: Excel 2011, EPIDAT 4.2 and SPSS; Chi-square and T-student tests (95% CI and p<0.05). Decrease in caries prevalence and severity during the 10 years under study (p<0.05). Statistically significant decrease in the prevalence and severity of caries after the implementation of the program benefiting 6-year-old children. As for the Oral Health Program for Pregnant Women and Sowing Smiles programs, they only had a statistically significant decrease in the severity of caries. A positive impact of all the public policies studied was observed, mainly in the severity of caries over the years under study. Statistical comparisons with previous studies cannot be made because they present very dissimilar methodologies. The relevance of a correct recording of the indices in the MSR should be emphasized. It is necessary to carry out epidemiological surveillance according to the methodologies and times indicated in order to evaluate the role played by prevention and promotion as set out in the strategic objectives of the decade that has just ended.

Estado de salud oral de pacientes hospitalizados con trastornos mentales: Revisión sistemática de la literatura / Oral Health Status of Hospitalized Patients with Mental Disorders: Systematic Review of the Literature

RESUMEN De acuerdo a la literatura, los pacientes hospitalizados con trastornos mentales (TM), tienen mayor riesgo a desarrollar caries y enfermedad periodontal que la población general, asociado a la dificultad motora para hacerse una adecuada higiene oral, a los efectos adversos que ocasionan los medicamentos para el control de los síntomas psiquiátricos y a la falta de cuidado oral y atención clínica. El objetivo era realizar una revisión sistemática de la literatura sobre el estado de salud oral de pacientes hospitalizados con TM. Se hizo una búsqueda sistemática de la literatura en PubMed, de acuerdo con la metodología de la declaración PRISMA, a través de los descriptores en salud MeSh "Dental Caries" y "Mental Disorders" a febrero de 2017. De acuerdo a los diferentes filtros que fueron aplicados, se obtuvieron 14 artículos que describieron el estado de salud oral -mediante el índice COP-D (dientes con caries, dientes con restauraciones, dientes perdidos y dientes con extracción mandatoria)- de pacientes hospitalizados con TM. Se debe promover el reconocimiento de la importancia de la salud oral por parte de los profesionales de la salud, cuidadores y familiares; se debe explorar la cavidad oral para determinar el estado de salud además de instruir a los pacientes y personal de apoyo en higiene oral; las instituciones de salud mental deben establecer un programa de intervención para eliminar focos infecciosos orales y luego implementar un programa preventivo multidisciplinario para mantener la salud oral de acuerdo al diagnóstico del TM.

ABSTRACT According to the literature, hospitalized patients with mental disorders have a higher risk of developing cavities and periodontal disease than the general population, associated with the motor difficulty to perform adequate oral hygiene, to the adverse effects caused by drugs for the control of psychiatric symptoms, as well as the lack of oral care and clinical care. The aim was to carry out a systematic review of the literature on the oral health status of hospitalized patients with mental disorders (MD). A systematic search of the literature was carried out in PubMed, according to the PRISMA statement methodology, through the MeSh health descriptors "Dental Caries" and "Mental Disorders" in February 2017. According to the different filters that were applied, 14 articles describing the oral health status were obtained - through the DMF-T index (teeth with cavities, teeth with restorations, missing teeth and teeth with necessary extraction)- of hospitalized patients with MD. The recognition of the importance of oral health by health professionals, carers and family members should be promoted; the oral cavity should be explored to determine the state of health in addition to instructing patients and support personnel in oral hygiene; mental health institutions should establish an intervention programme to eliminate oral infectious sites and then implement a multidisciplinary preventive programme to maintain oral health according to the MD diagnosis.

Free energy perturbation (FEP)-guided scaffold hopping

Scaffold hopping refers to computer-aided screening for active compounds with different structures against the same receptor to enrich privileged scaffolds, which is a topic of high interest in organic and medicinal chemistry. However, most approaches cannot efficiently predict the potency level of candidates after scaffold hopping. Herein, we identified potent PDE5 inhibitors with a novel scaffold via a free energy perturbation (FEP)-guided scaffold-hopping strategy, and FEP shows great advantages to precisely predict the theoretical binding potencies ΔG FEP between ligands and their target, which were more consistent with the experimental binding potencies ΔG EXP (the mean absolute deviations | Δ G FEP - Δ G EXP |  < 2 kcal/mol) than those ΔG MM-PBSA or ΔG MM-GBSA predicted by the MM-PBSA or MM-GBSA method. Lead L12 had an IC50 of 8.7 nmol/L and exhibited a different binding pattern in its crystal structure with PDE5 from the famous starting drug tadalafil. Our work provides the first report via the FEP-guided scaffold hopping strategy for potent inhibitor discovery with a novel scaffold, implying that it will have a variety of future applications in rational molecular design and drug discovery.

The Clinical Pattern and Prevalence of Streptococcus mutans and Streptococcus sobrinus among Adult and Children Patients with Dental Caries

Abstract Objective: To explore the clinical pattern, host factors, and presentation of Streptococcus mutans related to caries incidence among children and adults visiting Universitas Airlangga dental clinic. Material and Methods: This was an observational study with a cross-sectional approach with 50 patients in each group of carious children (6-12 years) and adults (18-35 years). Dental decay samples were taken by sterile excavator, put in a BHI's transport medium, and directly incubated overnight at 37 ºC. The next day, they were sub-cultured microbiologically in Tryptone Yeast Cystine Sucrose Bacitracin (TYCSB) selective medium. Bacterial species and serogroups were examined by PCR. All patient's data were collected from medical records and direct observation. Results: Caries were mostly media type in both children and adults. Oral hygiene (OHIS) in children was higher than in adults but not significantly different according to their DMFT. The highest scores for decay, missed and filled teeth were 16, 8 and 7, with an average of 6.82, 1.22 and 0.63, considered quite high. Conclusion: The prevalence of S. mutans was higher in children's caries than in adults, but among the adult patients the co-incidence of S. mutans and S. sobrinus was associated with higher DMFT. The mutans serotypes e, f, and d were more prevalent among children than adults.

Indicadores de salud oral en niños y adolescentes con parálisis cerebral de centros especializados de Lima- Perú, periodo 2012- 2013 / Oral health indicators in children and adolescents with cerebral palsy from specialized centers of Lima- Peru, 2012- 2013 period

Objetivo. Evaluar indicadores de salud oral en niños y adolescentes con parálisis cerebral en Lima-Perú. Métodos. Estudio observacional, descriptivo y transversal de una muestra de 171 pacientes de dos centros de referencia nacional especializados, periodo 2012- 2013, que cumplieron los criterios de inclusión. Para los índices de higiene oral (IHO) de Greene & Vermillion, índice de dientes cariados, perdidos y obturados (CPOD) y análisis de maloclusión dentaria (MD) se evaluaron 126 niños (6,0-11,9 años) y 45 adolescentes (12,0-19,0 años). Resultados. El IHO fue de 2,55 (malo) en el 91,8%, IHO regular en el 8,2% y ninguno mostró IHO bueno, observándose el mismo comportamiento en ambos grupos etarios. La prevalencia de caries fue 100% y CPOD de 4,55 ±1,56; los niños registraron CPOD de 4,52 ±1,537 y los adolescentes CPOD de 4,64 ±1,626. El 74,3% mostró MD, los niños evidenciaron MD en el 69,8% y los adolescentes mostraron 86,7%. En los niños, se observó relación molar (RM) Clase I derecha en el 42,1% e izquierda en el 44,4%; los adolescentes evidenciaron RM Clase III derecha en el 42,2% e izquierda en el 37,8%. Para los niños, el overbite (OB) no fue registrable en el 33,3% y normal en el 29,4%; en adolescentes, se registró OB normal en el 40%. Se observó con mayor frecuencia línea media dentaria desviada hacia el lado izquierdo. Conclusiones. En la mayoría de niños y adolescentes con parálisis cerebral de centros especializados se encontró alto índice de caries CPOD, mala higiene oral y presencia de maloclusiones.

Objective. To evaluate oral health indicators in children and adolescents with cerebral palsy in Lima-Peru. Methods. An observational, descriptive and cross-sectional study of a sample of 171 patients from two specialized national referral centers for the 2012- 2013 period who met the inclusion criteria. For the Greene & Vermillion oral hygiene index (OHI), decayed, missing and filled teeth (DMFT) and the dental malocclusion (DM) analysis, 126 children (6.0-11.9 years-old) and 45 adolescents (12.0-19.0 years- old) were evaluated. Results. The OHI was 2.55 (poor hygiene) in the 91.8%, regular OHI in the 8.2% and no one showed a good IHO, observing the same behavior in both age groups. The prevalence of caries was 100% and the DMFT was 4.55 ± 1.56; the children registered a DMFT of 4.52 ± 1.537 and the adolescents 4.64 ± 1.626. The DM was present in 74.3%; the children showed a 69,8% of DM and the adolescents showed 86.7%. In children, a right class I molar relationship (MR) was observed in 42.1% and a left MR in 44.4%; the adolescents showed right Class III in 42.2% and left in 37.8%. In children, the overbite (OB) was not registered in the 33.3% of the cases and it was normal in the 29.4%; the adolescents registered a normal OB in 40%. It was more frequently observed a deviation of the dental midline to the left. Conclusions. In most children and adolescents with cerebral palsy from specialized centers, a high index of DMFT caries, poor oral hygiene and the presence of malocclusions were found.

A cross-sectional study on the level of severity of dental caries in adults / Estudio transversal sobre nivel de severidad de caries dental en adultos

Introduction: Oral diseases affect some 3.9 billion people worldwide, the most prevalent are dental caries, gingivitis, and periodontitis. Untreated dental caries lesions affect 35% of the population. Objective: To determine the level of severity of dental caries lesions in adults treated at public dental services in the cities of Asunción and Pirayú, Paraguay, in 2 017. Material and Methods: Sociodemographic and clinical variables of oral health status were evaluated by means of a cross-sectional study using consecutive sampling. Two dentists were calibrated to perform the oral examination. Caries experience was evaluated using the DMF-T index. The Chi square test and Fisher's exact test were applied, with a confidence level of 95%. Results:333 subjects with a mean age of 35 years participated in the study, 77.2% were females, and 64.0% did not have access to private health care services. The DMF-T index was 11.43 (SD=6.7); 12.6% obtained a very low level, 35.7% low level, 41.7% had a medium level, and 9.9% had a high level in the DMF-T index. The DMF-T index was significantly higher in females (p=0.001), in the age range of 50 to 59 years (p<0.001), in those who did not have access to private health services (p=0.008), in those who reported a negative self-evaluation of their oral health (p=0.04), in those with a normal molar ratio (p=0.023) and a very severe aesthetic index (p<0 . 0 01). Conclusion: The general level of severity of global caries was medium and associated with sociodemographic and clinical variables.

Introducción: Las enfermedades orales afectan a 3,9 billones de personas a nivel mundial, siendo las más prevalentes la caries dental, la gingivitis y periodontitis; afectando al 35% de la población las lesiones de caries dental no tratadas. Objetivo: Determinar el nivel de severidad de lesiones de caries dental en adultos que acuden a servicios odontológicos públicos en las ciudades de Asunción y Pirayú, en el Paraguay, en el año 2017. Material y Métodos: Estudio transversal donde se evaluaron variables sociodemográficas y clínicas del estado de salud oral. El muestreo fue de casos consecutivos. Dos odontólogos fueron calibrados para realizar el examen oral. La experiencia de caries fue evaluada mediante el índice CPO-D. Se aplicaron las pruebas Chi cuadrado y Test exacto de Fisher, con un nivel de confianza del 95%. Resultados: Participaron del estudio 333 sujetos, con edad promedio de 35 años, el 77,2% mujeres y el 64,0% no tenía acceso a servicios de salud privado. El índice CPO-D fue de 11,43 (DE = 6,7). El 12,6% obtuvo un nivel muy bajo, el 35,7% nivel bajo, el 41,7% tuvo nivel medio y el 9,9% nivel alto del CPO-D, siendo significativamente más elevado en mujeres (p= 0, 0 01), en la edad de 50 a 59 años (p<0,001), en aquellos que no cuentan con acceso a servicios de salud privado (p=0,008), los que relataron una autoevaluación negativa de su salud bucal (p=0,04), los que tenían una relación molar normal (p=0,023) e índice de estética muy grave (p<0, 0 01). Conclusión: El nivel general de severidad de caries global fue medio, se asoció con variables sociodemográficas y clínicas.

Uptake and trafficking of different sized PLGA nanoparticles by dendritic cells in imiquimod-induced psoriasis-like mice model

Psoriasis is an autoimmune inflammatory disease, where dendritic cells (DCs) play an important role in its pathogenesis. In our previous work, we have demonstrated that topical delivery of curcumin-loaded poly (lactic-

Discovery of novel diarylamides as orally active diuretics targeting urea transporters

Urea transporters (UT) play a vital role in the mechanism of urine concentration and are recognized as novel targets for the development of salt-sparing diuretics. Thus, UT inhibitors are promising for development as novel diuretics. In the present study, a novel UT inhibitor with a diarylamide scaffold was discovered by high-throughput screening. Optimization of the inhibitor led to the identification of a promising preclinical candidate,

Fatores relacionados à cárie dentária em escolares de 15-19 anos de Manaus, Amazonas: um estudo transversal / Associated factors of tooth decay in 15-19-year-old students of Manaus, Amazonas: a cross-sectional study

Objetivo: Avaliar a experiência de cárie dentária e fatores relacionados em adolescentes de 15 a 19 anos de uma escola pública de Manaus-AM. Métodos: O delineamento do estudo foi do tipo transversal, cuja amostra foi constituída por 103 escolares. Para avaliar a cárie dentária foram realizados exames clínicos utilizando o Índice CPO-D (cariados, perdidos, obturados por dente) para avaliar presença de cárie dentária em ficha individual. Também foram aplicados dois questionários referentes aos hábitos de higiene bucal e à percepção da presença de dor dentária nos últimos seis meses e impacto das condições de saúde bucal na vida diária. O Índice Significant Caries Index (SIC) foi utilizado para avaliar a presença da doença cárie dentária em um terço da população com maior CPO-D. Para análise dos dados foram utilizados os programas Microsoft Excel®e Statistical Package for the Social Sciences (SPSS), adotando o nível de significância de 0,05. Para verificar a hipótese de associação entre variáveis foi utilizado o teste Qui-quadrado de Pearson. Resultados: A média do índice CPO-D encontrada foi de 1,2 considerada baixa; sendo o componente cariado (C) o responsável pela maior parte do Índice CPO-D. O Índice SIC foi de 4,4 evidenciando que um terço da amostra apresentava Índice CPO muito superior à média encontrada, mostrando desigualdade na distribuição da doença no grupo estudado. A frequência de escovação por 3 vezes ao dia foi relatada pela maioria dos adolescentes (57,3%). No entanto, sobre a frequência de consulta dos adolescentes ao cirurgião-dentista, constatou-se que 48,6% dos estudantes nunca procuraram atendimento. Houve relação estatisticamente significante entre presença de cárie dentária e irritabilidade causada pelos dentes (p = 0,011) e dificuldade para falar (p = 0,007). Conclusão: Este estudo apontou baixa experiência de cárie dentária, sendo a frequência de escovação por 3 vezes ao dia relatada pela maioria dos adolescentes. Houve relação estatisticamente significante entre presença de cárie dentária e as questões sobre incômodo ao escovar os dentes e dificuldade para falar.

Aim:To evaluate the experience of tooth decay and its associated factors in teenagers ranging from 15 to 19 years of age in a public high school in Manaus, Amazonas, Brazil. Methods: This study used a cross-sectional design, whose sample amount was a total of 103 students. To evaluate tooth decay, clinical exams were performed using the DMF-T index (decayed, missing, and filled teeth) to assess the presence of tooth decay (DMF-T) on an individual data record. Two questionnaires were applied regarding oral hygiene habits, perception of the presence of dental pain in the last six months, and impact of oral health conditions on daily life. The Significant Caries Index (SIC Index) was used to assess the presence of tooth decay disease in one third of the population with the highest DMF-T. For data analysis, the Microsoft Excel® and Statistical Package for the Social Sciences (SPSS) programs were used, adopting a significance level of 0.05. Pearson's chi-square test was used to verify the hypothesis of association between variables. Results:The DMF-T index was 1.2, which is considered low, while the carious component (C) was the most prevalent of the DMF-T Index. The SIC Index was 4.4, showing that one third of the sample had a DMF-T Index that was much higher than the average, revealing an unequal distribution of the disease within the studied group. The frequency of brushing teeth 3 times a day was reported by most teenagers (57.3%). However, regarding the frequency of visits to the dentist, it was found that 48.6% of the students had never sought out dental care. There was a statistically significant relationship between the presence of tooth decay and questions about irritability caused by teeth (p = 0.011) and difficulty in speaking (p = 0.007). Conclusion:This study showed a low experience of tooth decay, with the frequency of brushing 3 times a day reported by most adolescents. There was a statistically significant relationship between the presence of tooth decay and difficulty in speaking.

The role of health literacy as a factor associated with tooth loss / O papel da literacia em saúde como fator associado às perdas dentárias

ABSTRACT OBJECTIVE The objective was to analyze the role of health literacy (HL) as a factor associated with tooth loss among users of the Brazilian Health System with chronic non-communicable diseases. METHODS The cross-sectional analytical study was conducted with adult and elderly users chosen at ten Family Health Clinics in a draw in the town of Piracicaba, São Paulo State, Brazil. A questionnaire was applied with sociodemographic data (sex, age, skin color and education), behavioral data (brushing and flossing), determinants in health (type of dental health services and how often) and clinical data (pain). Mouth conditions were collected by intraoral examination of visible dental biofilm and community Pediodontal Index. The systemic clinical conditions (blood glucose, glycated hemoglobin and blood pressure) were extracted from the medical records. The explanatory variable was HL (low, medium and high), measured with the Health Literacy Scale (HLS-14). RESULTS The outcome was tooth loss measured by the index of decayed, missing and filled teeth. Logistic regression was performed using a conceptual model for HL (p < 0.05). For the 238 subjects, the mean age was 62.7 years (± 10.55). Tooth loss was associated with HL in regression models adjusted by type of dental service, dental frequency, and dental floss. In the final model, the factors associated with tooth loss are older age (OR = 1,12; 95%CI: 1,07-1,17), a lower education (OR = 3,43; 95%CI: 1,17-10,10), irregular use of dental floss (OR = 4,58; 95%CI: 1.75 in-7,31), irregular use of dental services (n = 2,60; 95% 1,32-5,12), periodontal pocket (> 4 mm) (n = 0,31; 95%CI: 0,01-0,08), having visible dental biofilm (OR = 7,23; 95%CI: 3,19-16,41) and a higher level of blood sugar (glucose) (n = 1,98; 95%CI: 1.00-3,92). CONCLUSIONS tooth loss was associated with HL when adjusted by health behaviors; when sociodemographic variables and clinical conditions were included, it was less significant. In the final model, behaviors, determinants in health and clinical conditions were risk indicators of tooth loss, showing the multifactorial nature of this phenomenon.

RESUMO OBJETIVO O objetivo foi analisar o papel da Literacia em Saúde (LS) como fator associado às perdas dentárias entre usuários do Sistema Único de Saúde com doenças crônicas não transmissíveis. MÉTODOS O estudo transversal e analítico foi conduzido com usuários adultos e idosos selecionados em dez Unidades de Saúde da Família sorteadas, em Piracicaba - SP, Brasil. Foi aplicado um questionário com dados sociodemográficos (sexo, idade, cor da pele e escolaridade), comportamentais (escovação e uso de fio dental), determinantes em saúde (tipo e frequência de uso de serviço de saúde médico e odontológico) e clínica (dor). As condições bucais foram coletadas por exame intrabucal do biofilme dental visível e Índice Pediodontal Comunitário. As condições clínicas sistêmicas (glicemia, hemoglobina glicada e pressóricas) foram extraídas dos prontuários. A variável explanatória foi a LS (baixa, média e alta), medida pelo Health Literacy Scale (HLS-14). RESULTADOS O desfecho foi à perda dentária medida pelo Índice de dentes permanentes cariados, perdidos e obturados. Foi realizada regressão logística com uso de um modelo conceitual para a LS (p < 0,05). Para os 238 indivíduos, a média de idade foi 62,7 anos (± 10,55). A perda dentária esteve associada à LS nos modelos de regressão ajustados por tipo de serviço odontológico, frequência odontológica e uso de fio dental. No modelo final, a perda dentária teve como fatores associados a maior idade (OR = 1,12; IC95% 1,07-1,17), menor escolaridade (OR = 3,43; IC95% 1,17-10,10), ao uso irregular de fio dental (OR = 4,58; IC95% 1,75-7,31), uso irregular do serviço odontológico (OR = 2,60; IC95% 1,32-5,12), bolsa periodontal (> 4mm) (OR = 0,31; IC95% 0,01-0,08), ter biofilme dental visível (OR = 7,23; IC95% 3,19-16,41) e maior índice de glicemia (OR = 1,98; IC95% 1,00-3,92). CONCLUSÕES A perda dentária esteve associada à LS quando ajustada por comportamentos em saúde, a partir da inclusão das variáveis sociodemográficas e condições clínicas ela perdeu a significância. No modelo final, comportamentos, determinantes em saúde e condições clínicas foram indicadores de risco da perda dentária, demonstrando a multifatorialidade envolvida neste fenômeno.

Impact of Non-Weighting in the Analysis of Data Obtained from Complex Samples

Abstract Objective: To compare the estimates obtained, considering or not the weighting data. Material and Methods: Secondary data from the Oral Health Survey of the State of São Paulo (SBSP2015) was used for calculation of mean estimates, standard errors of the mean and confidence intervals (CI) for the DMFT index and components (decayed, lost and filled), in the age group of 35-44 years. Multiple logistic regression models were estimated, considering or not the weighting from the sampling plan (p<0.05). Results: It was observed that the estimates of the DMFT index and the carious component did not vary much when the design was considered or not (1.1% and 2.0%, respectively). However, the data referring to the lost and filled component showed greater differences between the values of the means. The averages fluctuated up and down by up to 6.7% for weighted versus unweighted analyses. The standard error was underestimated in the unweighted analysis and the confidence interval showed variations. Differences between the regression models obtained by the weighted and unweighted analysis of the data were detected. Conclusion: Although weighted and unweighted models presented differences of less than 10% in estimates of the mean, confidence intervals, as well as statistical inferences, were different. Thus, weighting should be applied in the population base data analysis collected by sampling with complex designs.

Dental caries surveys: considerations about reproducibility / Inquéritos de cárie dentária: considerações sobre a reprodutibilidade

Aim:To evaluate the impact of the recording of teeth whose clinical conditions rarely vary (anterior teeth and third molars) in inter-examiner agreement measurements. Methods:Clinical data from 56 schoolchildren, 12 years of age, previously collected by two examiners, according to the "Oral Health Surveys: basic methods" codes and criteria, were analyzed in the present study. The effects from including/excluding such teeth upon reproducibility were measured by general percentage agreement (GPA) and Kappa statistics (к) performances. Results: The exclusion of anterior teeth associated with the inclusion of third molars produced a decrease in GPA that was simultaneous to an increase in the weighted Kappa (nominal data) and simple (dichotomous data) values. The incorrect inclusion of third molars (GPA = 100%; к = + 1) in the reproducibility measurement artificially increased the inter-examiner Kappa values. Conclusion: The inclusion/exclusion of anterior teeth and third molars, seeking a more reliable agreement among examiners, can have a positive or negative impact on the measured reproducibility values. A clear warning about the impact of including third molars in the reproducibility measurement, in the 12 years old age group, should be performed in "Oral Health Surveys: basic methods" and similar manuals.

Objetivo: Avaliar o impacto do registro de dentes anteriores e terceiros molares, cujas condições clínicas pouco variam, sobre as mensurações de concordância inter-examinadores. Métodos: Dados clínicos de 56 escolares de 12 anos de idade, previamente coletados por 2 examinadores, segundo os códigos e critérios expressos no "Levantamentos em Saúde Bucal: métodos básicos" foram analisados neste estudo. Os efeitos da inclusão/exclusão destes dentes sobre a concordância inter-examinadores foram mensurados calculando-se a porcentagem geral de concordância (GPA) e estatística Kappa (к). Resultados:A inclusão de terceiros molares aumentou a GPA para dados dicotomizados ou não. A exclusão de dentes anteriores diminuiu a GPA para dados dicotomizados ou não. Quando associada à inclusão de terceiros molares, sob perfeita concordância (к = +1), os valores de Kappa foram artificialmente aumentados tanto para dados dicotomizados quanto não-dicotomizados. Conclusão: A inclusão/exclusão de dentes anteriores e/ou de terceiros molares, no sentido de se evidenciar melhor as discordâncias entre examinadores, podem impactar positiva ou negativamente sobre a fidedignidade da reprodutibilidade mensurada. Uma advertência clara sobre o impacto da inclusão dos dentes terceiros molares no cálculo da reprodutibilidade, para a faixa etária de 12 anos, deveria estar presente no "Levantamentos em Saúde Bucal: métodos básicos" e manuais semelhantes.

Condições de Saúde bucal e acuidade visual dos estudantes em um município do Baixo Amazonas / Condiciones de salud bucal y agudeza visual de estudiantes en una ciudad de Baixo Amazonas / Oral health and visual acuity conditions of students in a municipality of Baixo Amazonas

Resumo Objetivo Avaliar a prevalência da cárie dentária e da deficiência visual nos escolares do ensino fundamental da rede pública de ensino de Barreirinha-AM e verificar os fatores associados a estas condições. Método Estudo transversal, com 1.828 estudantes entre 06 e 17 anos, da rede pública de ensino, Barreirinha. A avaliação da cárie dentária seguiu as recomendações da Organização Mundial da Saúde utilizando os critérios estabelecidos para as condições dentárias, tanto para dentes decíduos, quanto para permanentes: cariados, perdidos e obturados. O índice Significant Caries Index mediu a severidade da cárie dentária nos indivíduos mais afetados com a doença. Realizou-se avaliação para acuidade visual e analisou-se idade, sexo e escola. Resultados Evidenciou-se elevada prevalência de cárie dentária, desigualdade em sua distribuição e associação entre esta doença e sexo (p = 0,005). A prevalência de dificuldades visuais entre os escolares foi baixa. Conclusão e implicações para prática O estudo sugere carência de tratamento odontológico restaurador e elevada prevalência de cárie dentária, evidenciando a necessidade de planejamento e desenvolvimento de ações de promoção de saúde bucal, com o intuito de minimizar os agravos provocados pela doença.

Resumen Objetivo Evaluar la prevalencia de caries dentales y discapacidad visual en estudiantes de la enseñanza primaria del sistema escolar público de Barreirinha-AM, y verificar los factores asociados con estas condiciones. Método Estudio transversal realizado con 1.828 estudiantes entre 06 y 17 años, de escuelas públicas de Barreirinha-AM. La evaluación de las caries dentales siguió las recomendaciones de la Organización Mundial de la Salud, utilizando los criterios establecidos para las condiciones dentales, tanto para dientes temporales como permanentes: cariados, perdidos y obturados. El índice Significant Caries Index midió la gravedad de la carie dental en las personas más afectadas por la enfermedad. Se realizó la evaluación para agudeza visual y se analizó edad, sexo y nivel educativo. Resultados Hubo alta prevalencia de carie dental, desigualdad en su distribución y asociación entre esta enfermedad y el sexo (p = 0,005). La prevalencia de dificultades visuales entre los estudiantes fue baja. Conclusión e implicaciones para la práctica El estudio sugiere una carencia de tratamiento dental restaurador y una alta prevalencia de caries dentales, evidenciando la necesidad de planificación y desarrollo de acciones de promoción a la salud bucal, con el fin de minimizar los problemas ocasionados por la enfermedad.

Abstract Objective To evaluate the prevalence of dental caries and visual acuity deficiency in elementary school students of the public school system in the municipality of Barreirinha- AM and check the factors associated with these conditions. Method Cross-sectional study with 1,828 students aged 6 to 17 in the public school system of the municipality-of Barreirinha-AM. The dental cavity evaluation followed the recommendations of the World Health Organization using the established criteria for dental conditions, for deciduous as for permanent teeth: decayed, missing and filled. The Significant Caries Index was used to measure the dental caries severity in the individuals most affected by this disease. Visual acuity was assessed and age, sex and school were analyzed. Results It became evident high prevalence of dental cavities, inequality in its distribution, and relation between this disease and gender (p=0.005). The visual deficit frequency was low among the students. Conclusion and implications for practice The study indicates a lack of dental restoration treatment and high dental cavity prevalence, highlighting the need for planning and development of oral health promotion actions, with the purpose of minimizing the aggravations caused by the disease.

Association between demarcated enamel hypomineralization on second primary molars and dental caries in childhood / Associações entre hipomineralização demarcada de esmante nos segundos molares decíduos e cárie dentària na infância

ABSTRACT Hypomineralized Second Primary Molars (HSPM) is the name used to describe the presence of demarcated enamel hypomineralization in second primary molars. HSPM has been compared with Molar Incisor Hypomineralization (MIH) as regards its clinical appearance and consequences. The aim of this study was to investigate associations between HSPM and dental caries in childhood. It was a cross-sectional population-based study that included 216 children aged 4-6 years from public schools in Botelhos, Brazil. Children with all second primary molars erupted were eligible for participation. Clinical examination was performed by one calibrated examiner. HSPM was recorded according to modified European Academy of Paediatric Dentistry criteria. The main outcome was dental caries experience as indicated by the dmft index (%dmft>0) according to WHO criteria. Chi-square test and Logistic Regression Model were used to adjust the results for effects of covariates Among the 216 children examined, 22.2% presented HSPM. After adjustment for logistic regression, children with HSPM were found to have a 2.28 times greater chance of presenting dental caries. Our results reinforce the importance of HSPM in caries development in children, which should be considered by public health dentists in the process of planning actions aimed at this population.

RESUMO A hipomineralizacao de segundo molar deciduo (HSMD) é de-nominação utilizada para descrever a presenga de hipomineralização demarcada do esmalte nos segundos molares decídus. A HSMD foi comparada com a hipomineralização de molares e incisivos (HMI) no que diz respeito á aparencia e as conse-quencias clínicas. O objetivo deste estudo foi investigar asso-ciações entre HSMD e cárie na infáncia. Foi realiza um estudo transversal de base populacional, composto por 216 criangas de 4 a 6 anos de idade de escolas públicas de Botelhos, Brasil. As criangas com todos os segundos molares deciduos foram elegíveis para participação. O exame clínico foi realizado por um examinador calibrado. A HSMD foi registrada de acordo com os critérios modificados da European Academy of Paediatric Dentistry. O desfecho principal foi a experiencia de cárie dentària nos dentes deciduos conforme o índice ceo (% ceo> 0), segundo os critérios da OMS. Os testes de Qui-quadrado e o modelo de regressao logística foram utilizados para ajustar os resultados dos efeitos das covariáveis. Verificou-se que entre as 216 criangas examinadas, 22,2% apresentaram HSMD. Após o ajuste da regressao logística, as criangas com HSMD tiveram 2,28 vezes mais chances de apresentar cárie dentària. Nossos resultados reforgam a importáncia do HSMD no desenvolvimento da cárie em criangas, fato que deve ser considerado pelos dentistas de saúde pública no processo de planejamento de ações voltadas a essa população.

Dental caries and oral health behavior assessments among portuguese adolescents / Caries dental y evaluaciones del comportamiento de salud bucal en adolescentes portugueses

Introduction: Adolescents have a high risk of developing caries in Portugal. The present study is designed to assess dental caries experience among the adolescents by the application of DMFT index, characterize the oral health risk factors and to determine the association between caries experience and socio-demographic variables. The characterization of the oral health behaviors of adolescents of the central region of Portugal will help in the development of specific oral health education strategies to improve oral health among the local communities. Material and methods: A cross-sectional study was conducted among a convenient sample of 694 adolescents aged 12 to 18 years attending public schools in two Portuguese districts using a structured questionnaire designed to investigate oral health and behavior of participants. In addition, a clinical examination was carried out noting the decayed, missing and filled teeth. A descriptive analysis of the variables was performed using the Chi-square, Mann-Whitney and Kruskal-Wallis tests (p<0.05). A multivariate analysis was applied for analysis of the association between variables. Results: The mean DMFT index score of 2.91±2.9 was obtained. Of the total sample, 73% consumed sugary food daily, 50.1% considered having good oral health and 70.8% did not report pain in the last 12 months. Most adolescents (79.4%) brushed their teeth daily and 60% did not use dental floss. Of the total sample, 96.4% had a dental appointment in the last 12 months, 46.4% of which was for preventive purposes. Applying the Chi-square statistical test, we verified that the adolescents who brush their teeth daily presented a good perception about their oral health (p<0.001), the DMFT index scores were associated with the residence area (p=0.01) and the presence of dental caries was associated with the perception of oral health (p=0.049) and sugary food intake (p=0.029).Conclusion: Portuguese adolescents presented a low DMFT index. The DMFT index was associated with residence area, perception of oral health and sugary food intake. Daily toothbrushing was associated with self-perception of oral health. It is suggested that oral health promotion and prevention programs should aim to reduce the risks of oral disease development.

Introducción: Los adolescentes tienen un alto riesgo de desarrollar caries en Portugal. El presente estudio está diseñado para evaluar la experiencia de caries dental entre los adolescentes mediante la aplicación del índice CPOD, caracterizar los factores de riesgo para la salud bucal y determinar la asociación entre la experiencia de caries y las variables sociodemográficas. La caracterización de los comportamientos de salud bucal de los adolescentes de la región central de Portugal ayudará en el desarrollo de estrategias específicas de educación en salud bucal para mejorar la salud bucal entre las comunidades locales. Material y Métodos: Se realizó un estudio transversal en una muestra por conveniencia de 694 adolescentes de 12 a 18 años que asisten a escuelas públicas en dos distritos portugueses utilizando un cuestionario estructurado diseñado para investigar la salud bucal y el comportamiento de los participantes. Además, se llevó a cabo un examen clínico observando los dientes cariados, faltantes y obturados. Se realizó un análisis descriptivo de las variables mediante las pruebas de Chi-cuadrado, Mann-Whitney y Kruskal-Wallis (p <0,05). Se aplicó un análisis multivariado para el análisis de la asociación entre variables. Resultados: Se obtuvo la puntuación media del índice CPOD de 2,91 ± 2,9. Del total de la muestra, el 73% consumía alimentos azucarados diariamente, el 50,1% consideró tener buena salud bucal y el 70,8% no refirió dolor en los últimos 12 meses. La mayoría de los adolescentes (79,4%) se cepillaban los dientes a diario y el 60% no usaba hilo dental. Del total de la muestra, el 96,4% tuvo cita con el dentista en los últimos 12 meses, de la cual el 46,4% fue con fines preventivos. Aplicando la prueba estadística de Chi-cuadrado, verificamos que los adolescentes que se cepillan los dientes diariamente presentaban una buena percepción sobre su salud bucal (p <0.001), las puntuaciones del índice CPOD se asociaron al área de residencia (p = 0.01) y la caries dental se asoció con la percepción de salud bucal (p = 0,049) y con la ingesta de alimentos azucarados (p = 0,029). Conclusión: Los adolescentes portugueses presentaron un índice CPOD bajo. El índice CPOD se asoció con el área de residencia, la percepción de salud bucal y la ingesta de alimentos azucarados. El cepillado diario de los dientes se asoció con la autopercepción de la salud bucal. Se sugiere que los programas de promoción y prevención de la salud bucal deben ser enfocados en reducir los riesgos de desarrollo de enfermedades bucodentales.

The Relation Between Decay Missing Filled-Teeth (DMF-t), Body Mass Index (BMI) with Salivary Human Beta-3 (HBD-3) Secretion in Children with Caries and Free Caries

@#Introduction: Dental caries in children is a major problem of mouth disease throughout the world, so too is there currently an increase in health problems in children due to obesity. Human Beta defensing(HBD) has been found in saliva and from several studies stated that HBD aside from being a broad-spectrum antimicrobial can act as an immunomodulator. The purpose of this study is to reveal whether there is a relationship between obesity and HBD-3 salivary concentration in caries patients and caries-free patients. Methods: This cross-sectional observational study was involved 62 children with caries and caries-free, aged 9-11 years, students at Qommarudin Islamic Boarding School, Gresik, East Java Indonesia. dental caries examination, carried out in accordance with World Health Organization (WHO) diagnostic criteria. Body mass index (BMI) was measured from the height and weight of individuals, HBD3 concentrations were tested with an ELISA kit from Bioassay Technology Laboratory (China) from saliva samples. Evaluate the results with the Kruskal Wallis test, followed by the Mann-Whitney test. The level of significance used in this statistical test was 0.05. Results: there was a relationship between BMI level and HBD-3 concentration in the caries group (p <0.05, p = 0.009) with a moderate level of association. but there was no significant relationship in the caries-free group (p> 0.05, p = 0.189). Conclusion: There was an association between BMI and HBD-3 salivary concentration in caries patients but there was no relationship in the caries-free group.

Evaluation of effect of oral health intervention on children in Shaoshan area of Hunan province / 北京大学学报(医学版)

OBJECTIVE@#To understand the oral health status of children aged 3-12 in Shaoshan area of Hunan province and to evaluate the role of oral health educations based on community such as fluoride varnish, oral hygiene introduction in improving the oral health of children in the area so as to gain expe-rience.@*METHODS@#The study used cluster sampling to select 3 kindergartens and 2 primary schools in different economic development areas of Shaoshan. Oral health status survey and interventions were conducted in December 2014 and September 2016, respectively. The average debris index, decayed missing filled teeth (deciduous teeth: dmft; permanent teeth: DMFT), and caries prevalence rate of children aged 3-6 years and 6-12 years were compared. At the same time, children aged 5 and 12 were used as representative populations to compare the indices as listed before and the caries prevalence rate of the first permanent molar in 12-year-old children was compared as well. Finally, health economic analysis was carried out based on the 2 years' result.@*RESULTS@#In this study, 992 children and 896 children in 2014 and 2016 were included respectively. As for children aged 3-6 years, the average debris index and dmft in 2016 were significantly less than that in 2014 (P < 0.001, P < 0.001), and the difference of DMFT was not significant (P=0.419). Children aged 6-12 years showed the same result, the average debris index and dmft in 2016 were significantly less than those in 2014 (P < 0.001, P=0.013), and the difference in DMFT was not significant (P=0.674). 173 and 179 5-year-old children were included in 2014 and 2016 respectively, and the dmft showed significant difference (P=0.038); the caries prevalence rate was 75.7% and 71.5%, respectively, which was also not significant (P=0.370). With respect to the 12-year-old children, 65 and 104 children were included and the differences in dmft and DMFT were not significant (P=0.133, P=0.171). The caries prevalence of the first permanent molar in the 12-year-old children was 36.9% and 26.9%, whose difference was not significant (P=0.171).@*CONCLUSION@#The application of fluoride varnish and oral health education can significantly reduce the dmft of children aged 3-12 years in Shaoshan area and significantly improve the oral hygiene status. DMFT, the caries prevalence rate of 5-year-old children's deciduous teeth and 12-year-old children's first permanent molar showed a decline.

Clinical Consequences of Untreated Dental Caries among Primary School Children: A Cross-Sectional Study

Abstract Objective: To evaluate the dental caries experience and clinical consequences of untreated dental caries (UDC) among primary school children of Al Jouf region, Saudi Arabia and to determine the correlation between dental caries experience and clinical consequences of UDC. Material and Methods: A 250 primary school children 6-7 years were recruited using systematic random sampling. The prevalence of dental caries in deciduous dentition was assessed by following WHO criteria using the dmft index and the clinical consequence of UDC was assessed with the pufa index. The pufa score was calculated cumulatively following the pufa diagnostic criteria. The Student's t-test was used to equate the mean dmft and pufa scores between boys and girls. The correlation between the dmft and the pufa scores was evaluated using Pearson's correlation coefficient (r), and the p-value was set at 0.05 for statistical significance. Results: Out of which 154 (61.60%) boys and 94 (37.60%) were girls. The mean (SD) values of dmft for boys reported to be 5.37 (± 3.31) and for girls 6.35 (± 3.27), which was statistically significant with gender (p<0.001). Statistically, significant mean values of pufa were 1.20 (± 1.37) in boys and 1.71 (± 1.58) in girls, respectively was observed (p<0.001). The Pearson correlation between dmft and pufa values showed a highly significant positive correlation among dmft and pufa values (r= 0.635, p<0.001). Conclusion: The present study revealed that high caries prevalence and experience of the clinical consequences of UDC in the primary dentition, and there was a strong positive correlation between dmft and pufa score values.