Caries prevention mechanism of the Xinjiang Mori Cortex based on network pharmacology and its effect on the main cariogenic bacteria / 口腔疾病防治

Objective@#To investigate the potential caries prevention mechanism of the Xinjiang Mori cortex and to analyze its effect on the main cariogenic bacteria.@*Methods@#The active components of the Xinjiang Mori cortex and the main targets were predicted and screened using the TCMSP database. The GeneCards, DisGENET and TTD databases were used to obtain caries-related targets. The common targets were derived, and core genes were screened. The enrichment analysis was performed using the DAVID data platform. Molecular docking was performed using AutoDock software. In in vitro antibacterial experiments, first, the 50% minimum inhibitory concentration (MIC50) and the minimum bactericidal concentration (MBC) of the Xinjiang Mori Cortex extract against Streptococcus mutans, Streptococcus sanguis and Actinomyces viscosus were determined and the growth curves were measured. The effects of the Xinjiang Mori Cortex extract on acid production, polysaccharide production and adhesion ability of Streptococcus mutans, Streptococcus sanguis and Actinomyces viscosus in the planktonic state were determined. The 50% minimum biofilm inhibition concentration (MBIC50) and 50% minimum biofilm reduction concentration (MBRC50) were determined by crystal violet staining, and biofilm morphology was visualized using scanning electron microscopy (SEM).@*Results@#The main active components of the Xinjiang Mori cortex included quercetin, kaempferol, and β-sitosterol. Tumor necrosis factor (TNF), interleukin-6 (IL-6), and interleukin-1beta (IL-1β) could be the most important targets of the Xinjiang Mori cortex for the prevention of dental caries. The enrichment analysis results showed that Mori cortex extract may have effects on the AGE-RAGE signaling pathway, IL-17 signaling pathway, and TNF signaling pathway. The antibacterial experiment results showed that the MIC50 values of Xinjiang Mori Cortex extract against Streptococcus mutans, Streptococcus sanguis and Actinomyces viscosus were 0.5, 0.5 and 0.25 mg/mL, respectively, and the MBCs were 4.0, 2.0 and 1.0 mg/mL, respectively. The inhibitory effect of Xinjiang Mori Cortex extract on the acid production, polysaccharide production and adhesion ability of three major cariogenic bacteria in the planktonic state was stronger than that of the control group, and the differences were statistically significant (P<0.05). The MBIC50 was 1.0, 1.0, and 0.5 mg/mL, and the MBRC50 was 4.0, 4.0, and 2.0 mg/mL. SEM observation showed that the amount of biofilm formation decreased with the drug concentration compared with the control group.@*Conclusion@#Xinjiang Mori cortex extract can prevent caries through quercetin, kaempferol, and β-sitosterol active ingredients, TNF、IL-6、IL-1β key targets and multiple pathways and inhibit the growth, acid production, polysaccharide production, and adhesion ability of three major cariogenic bacteria in the planktonic state and has some inhibitory effect on corticogenic biofilm formation.

Research progress on dental materials for preventing root caries / 口腔疾病防治

@#The high incidence and untreated rate of root caries, a common and frequently occurring oral disease with challenging treatment in elderly individuals, is the main cause of tooth loss among elderly people, as rapid development results in pulpitis and periapical periodontitis or residual crown and root, which has been regarded as one of the common chronic oral diseases seriously affecting the quality of life of elderly people. Thus, early intervention and prevention are important. Traditional dental materials for preventing root caries have been widely used in clinical practice; however, they have the disadvantages of tooth coloring, remineralization and low sterilization efficiency. A series of new dental materials for preventing root caries have gradually become a research hotspot recently, which have the advantages of promoting the mineralization of deep dental tissue, prolonging the action time and enhancing adhesion. Future caries prevention materials should be designed according to the characteristics of root surface caries and the application population and should be developed toward simplicity, high efficiency and low toxicity. This review describes current research regarding anti-caries prevention material application, serving as a theoretical underpinning for the research of root caries prevention materials, which is important for both promotion in the effective prevention of root caries and improvement in the status of oral health and the quality of life among old people.

Research progress on the relationship between free sugars and caries / 口腔疾病防治

@#Caries is a chronic infectious disease that occurs in the hard tissues of teeth. The interaction of oral microorganisms, host, food and time leads to the occurrence and progression of caries. Free sugar is an important food factor in the occurrence of dental caries. This paper reviews the research progress on the relationship between free sugar and caries in recent years, providing a reference for further clarifying the mechanism of the occurrence and progression of caries caused by free sugar and exploring the methods of caries prevention. The cariogenic mechanism of free sugar is multifaceted. Free sugar can not only be used by oral microorganisms in dental plaque biofilms to produce acid and synthesize intracellular and extracellular polysaccharides but also cause an imbalance in oral microecology and enhance gene expression related to the cariogenic toxicity of oral microorganisms. Based on the correlation between free sugar and caries, it is important to limit the intake amount and frequency of free sugar to prevent caries. This can be achieved mainly by formulating public health policies for reducing sugar, creating a low-sugar family environment with good eating habits, using sugar substitutes and using fluoride. There are few studies on the relationship between free sugar and oral microecology. More research is needed to better understand the effect of free sugar on oral microecology and its mechanism and to validate the caries-preventing effect of various sugar reduction measures. We believe such studies would open up new avenues for the effective prevention of caries.

Dental caries in 12-Year-Old schoolchildren who participate in a preventive and restorative dentistry program / Caries dental en escolares de 12 años que participan en un programa de odontología preventiva y rehabilitación oral

Abstract Since 2013, the Faculty of Dentistry of the University of Costa Rica has provided a preventive and restorative oral health program at Carmen Lyra Public School. The first generation of students that received dental care from this project were examined in 2019 for caries status. A total of 62 twelve-year-old schoolchildren were examined (31 boys and 31 girls). First, all teeth surfaces were cleaned with a brush and then rinsed. Subsequently, examination was performed in each person by a calibrated examiner using the International Caries Detection and Assessment System (ICDAS). Prevalence of dental caries was 59.7%. ICDAS code 2 was the most prevalent (68.8%), followed by 1 (19.3%), 5 (4.5%), 3 (3.5%), 6 (2.5%), and 4 (1.4%). Regarding number of carious surfaces, the highest prevalence was observed in the occlusal surfaces (77.3%), followed by the vestibular (13.9%), mesial (4.2%), palatal/ lingual (4,1%) and distal (0.5%). Of these carious surfaces, 7% were caries associated with restorations and were present only on the occlusal surfaces. Boys had more cavities than girls (54.1% compared to 45.9%), however, this difference was not significant. Regarding the condition of restorations in teeth, 92 dental restorations (resin or amalgam) were found in the population studied and were well adjusted. Most of these restorations were found on the occlusal surfaces (82.6%), followed by vestibular surfaces (8.7%,) palatal/lingual (5.4%) surfaces, mesial surfaces (3.3%), and no restorations were detected on the distal surfaces. Sealants were identified in 11.3% schoolchildren; 98% were identified on the occlusal surfaces and the other 2% were found on the palatal/lingual surfaces. DMFT Index was 1.6±0.71. The prevalence of dental caries in this sample was low compared to other studies in twelve-year-old schoolchildren in Costa Rica. This may suggest that the oral health program had a positive impact in the studied population.

Resumen Desde el año 2013, la Facultad de Odontología de la Universidad de Costa Rica ha brindado un programa de prevención y rehabilitación oral en la Escuela Carmen Lyra. La primera generación de estudiantes que recibieron atención dental por parte de este programa, fueron examinados en el año 2019 para determinar la prevalencia de caries. Se examinó a 62 escolares de 12 años (31 niños y 31 niñas). Primero, todas las superficies de los dientes se limpiaron con un cepillo y luego se enjuagaron. Posteriormente, el examen fue realizado en cada participante por un examinador calibrado utilizando el Sistema Internacional de Detección y Evaluación de Caries (ICDAS). La prevalencia de caries dental fue del 59,7%. El código ICDAS 2 fue el más prevalente (68,8%), seguido de 1 (19,3%), 5 (4,5%), 3 (3,5%), 6 (2,5%) y 4 (1,4%). En cuanto al número de superficies cariadas, la mayor prevalencia se observó en las superficies oclusales (77,3%), seguidas de las vestibulares (13,9%), mesiales (4,2%), palatinas/linguales (4,1%) y distales (0,5%). De estas superficies cariadas, el 7% eran caries asociadas con restauraciones y estaban presentes solo en las superficies oclusales. Los niños tenían más caries que las niñas (54,1% en comparación con el 45,9%), sin embargo, esta diferencia no fue significativa. En cuanto al estado de las restauraciones dentales, se encontraron 92 restauraciones dentales (resina o amalgama) en la población estudiada y se encontraban bien ajustadas. La mayoría de estas restauraciones se encontraron en las superficies oclusales (82,6%), seguidas de las superficies vestibulares (8,7%), superficies palatinas/linguales (5,4%), superficies mesiales (3,3%) y no se detectaron restauraciones en las superficies distales. Se identificaron sellantes de fosas y fisuras en el 11,3% de los escolares. El 98% de estos sellantes se identificó en las superficies oclusales y el otro 2% se encontró en las superficies palatino/lingual. El índice CPOD fue de 1,6±0.71. La prevalencia de caries dental en esta muestra fue baja en comparación con otros estudios en escolares de doce años en Costa Rica. Esto sugiere que el programa de salud bucal tuvo un impacto positivo en la población estudiada.

Cost-effectiveness analysis of the oral health promotion model in rural primary schools in Guangxi Zhuang Autonomous Region / 口腔疾病防治

Objective@#To evaluate the caries preventive effect and economic outcome of an oral health promotion model in rural primary schools in Guangxi Zhuang Autonomous Region.@*Methods@# In November 2015, a baseline survey was conducted on the caries prevalence of rural first graders in program areas, and then a program intervention was carried out on the first graders of target primary schools. The intervention methods included the distribution of oral health care products, oral health education, teacher training, etc. In 2020, the method of cluster random sampling was adopted to include the sixth graders who received the program intervention as first graders and were still available in 2020 as the intervention group. During this period, the sixth graders transferred from foreign schools who failed to receive the program intervention as first graders were included in the non-intervention group. The caries preventive effect was evaluated by analyzing the caries epidemiological data of 2 652 children aged 11-13 years, comparing the intervention and non-intervention group. The cost of the program was estimated by the structural analysis method. A decision tree model was established by TreeAge pro2019 and incorporated into the effect parameters and cost parameters for cost-effectiveness analysis and sensitivity analysis.@* Results @# The prevalence of caries in the intervention group was 54.8%, and the mean DMFT was 1.36 ± 1.64, both of which were lower than those in the non-intervention group. The difference in prevalence and mean DMFT between the two groups was statistically significant (P < 0.05). It costs CNY 319.83 per child to reduce suffering from caries. The number of patients with caries in the intervention group was the most sensitive indicator of an economic effect. The probability of a cost-effectiveness advantage for the program was 92.2%. @*Conclusion @# This oral health promotion model used in rural schools demonstrated a caries preventive effect that was very likely economically advantageous. It is of practical significance to improve and promote this model in the Guangxi Zhuang Autonomous Region.

Fluoride toothpaste, sanitary surveillance and the SUS: the case of Manaus-AM, Brazil / Dentifrício fluoretado, vigilância sanitária e o SUS: o caso de Manaus-AM

ABSTRACT OBJECTIVE To determine the anticaries potential of toothpastes distributed by the primary health care public clinics (UBS) of Manaus, AM. METHODS Ninety-nine tubes of toothpaste from four commercial brands were collected from October 7, 2019 to October 11, 2019 in 16 UBS. They were assigned a code by brand and source UBS. According to the information on the packaging, the four brands and their batches were formulated with sodium monofluorophosphate (Na2FPO3) and most (91%) had calcium carbonate (CaCO3) as an abrasive. We determined the concentrations of total fluoride (TF = TSF + InsF) and total soluble fluoride (TSF = F ions- or FPO32-), to certify whether they were in compliance with resolution ANVISA RDC No. 530 (maximum of 1,500 ppm TF) and whether they had anticaries potential (minimum of 1,000 ppm TSF). The analyses were performed with a ion- specific electrode. RESULTS The concentrations (ppm F) of TF [mean; standard deviation (SD); n] found in toothpaste brands A (1,502.3; SD = 45.6; n = 33), B (1,135.5; SD = 52.7; n = 48) and D (936.8; SD = 20.5; N = 8) were close to those stated on the package, 1,500, 1,100 and 1,000 ppm F, respectively. In toothpaste C, we found a mean of 274.1 ppm (SD = 219.7; n = 10) of TF, which diverges from the declared concentration of 1,500 ppm F. In addition, the five tubes of lot no. 11681118 of toothpaste C did not contain fluoride. Regarding TSF, with the exception of toothpaste D (937.9; SD = 40.29), the others had a lower concentration than their respective TF. CONCLUSION We found serious problems of quantity and quality of fluoride in toothpaste distributed by the SUS in Manaus, which shows the need for surveillance of these products and confirms the urgency of revising resolution RDC No. 530.

RESUMO OBJETIVO Determinar o potencial anticárie dos dentifrícios distribuídos pelas unidades básicas de saúde (UBS) de Manaus-AM. MÉTODOS Noventa e nove bisnagas de dentifrícios de quatro marcas comerciais foram coletadas de 7 de outubro de 2019 a 11 de outubro de 2019 em 16 UBS, que foram codificados por marca e UBS de origem. De acordo com a embalagem, os dentifrícios das quatro marcas e seus lotes foram formulados com monofluorofosfato de sódio (Na2FPO3) e a maioria (91%) tinha carbonato de cálcio (CaCO3) como abrasivo. Foram determinadas as concentrações de fluoreto total (FT = FST + Fins) e de fluoreto solúvel total (FST = íons F- ou FPO32-), para certificar se atendiam à resolução ANVISA RDC Nº 530 (máximo de 1.500 ppm de FT) e se tinham potencial anticárie (mínimo de 1.000 ppm de FST). As análises foram feitas com eletrodo íon específico. RESULTADOS As concentrações (ppm F) de FT [média; desvio padrão (DP); n] encontradas nos dentifrícios A (1.502,3; DP = 45,6; n = 33), B (1.135,5; DP = 52,7; n = 48) e D (936,8; DP = 20,5; n = 8) foram próximas ao descrito na embalagem, 1.500, 1.100 e 1.000 ppm F, respectivamente. No dentifrício C, foi encontrada média de 274,1 ppm (DP = 219,7; n = 10) de FT, divergindo da concentração declarada de 1.500 ppm F. Em acréscimo, as cinco bisnagas do lote no 11681118 do dentifrício C não foram fluoretadas. Quanto ao FST, à exceção do dentifrício D (937,9; DP = 40,29), os demais apresentaram concentração inferior ao seu respectivo FT. CONCLUSÃO Observou-se problemas graves de quantidade e qualidade do fluoreto nos dentifrícios distribuídos pelo SUS em Manaus, mostrando a necessidade de vigilância desses produtos e ratificando a urgência da revisão da resolução ANVISA RDC Nº 530.

Comparison of the Streptococcus mutans colony count changes in plaque following chlorhexidine (0.12%) mouth rinse and green tea extract (0.5%) mouth rinse in 8–12-year-old children

Background: Mouth rinses are solutions or liquids used to rinse the mouth to have a therapeutic effect by relieving infection or preventing dental caries due to their antimicrobial properties. Aims: This study was carried out to compare the effect of 0.12% chlorhexidine mouth rinse and 0.5% green tea extract mouth rinse on the colony-forming units (CFUs) of Streptococcus mutans in plaque in children. Materials and Methods: The sample for the study consisted of fifty schoolchildren aged 8–12 years with four or more (decay component) of decayed, missing, and filled teeth index. Children were divided randomly into two groups and were asked to rinse with the prescribed mouth rinse twice daily for 2 weeks under supervision. The plaque samples were collected at baseline (prerinsing) and postrinsing and tested for the CFUs of S. mutans. Results: The results of the study indicate that there was a statistically significant reduction (pre- and postrinsing) in S. mutans colony count in both the study groups. There was no statistically significant difference in the reduction of S. mutans colony count between 0.12% chlorhexidine mouth rinse group and 0.5% green tea mouth rinse group. Conclusion: Green tea mouth rinse is effective against S. mutans – one of the major dental plaque microorganisms.

Contributions of school context to caries on anterior teeth: a multilevel analysis

ABSTRACT OBJECTIVE To investigate whether oral health literacy (OHL) and school context are associated with untreated dental caries on the anterior teeth of adolescents. METHODS A representative cross-sectional study was conducted with 746 students aging 15 to 19 in the city of Campina Grande, Brazil. The guardians answered a questionnaire addressing sociodemographic data and the absence/presence of private health insurance. Two examiners were trained for the diagnosis of dental caries using the Nyvad criteria and the measurement of OHL using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) (Kappa > 0.80). Contextual aspects of the schools were obtained from the 2017 National School Census. Descriptive statistics were conducted, followed by unadjusted and adjusted robust negative binomial regression for complex samples (p < 0.05). RESULTS The average number of anterior teeth with untreated caries was 0.95 (SD = 1.77). Among individual factors, the male sex (RR = 1.64; 95%CI: 1.24-2.16), inadequate level of OHL (RR = 2.03; 95%CI: 1.13-1.63), marginal level of OHL (RR = 1.87; 95%CI: 1.05-3.33) and not having private health insurance (RR = 1.34; 95%CI: 1.07-1.68) were associated with untreated caries on anterior teeth. Among school contextual factors, the number of students in the classroom (RR = 2.64; 95%CI: 1.78-3.93), number of public oral health services in the district (RR = 0.14; 95%CI: 0.05-0.39) and average income of the district in which the school is located (RR = 0.99; 95%CI: 0.98-0.99) were associated with the outcome. CONCLUSIONS Sociodemographic factors, having private health insurance, OHL, and school context exerted an influence on the occurrence of untreated dental caries on anterior teeth in adolescents aging 15 to 19.

El desarrollo de la primera pasta dental con fluoruro. Semblanza histórica: en los 50 años del Oral Health Research Institute (OHRI) / Development of the first fluoridated toothpaste. Historical review:the 50th year of the Oral Health Research Institute (OHRI)

Siempre es importante el poder llevar a cabo algún tipo de reconocimiento a las personas involucradas en haber dejado aun el más mínimo tipo de legado en nuestra profesión. A título muy personal, la utilización de los fluoruros y, muy en especial su incorporación en la formulación de pastas dentales, ha sido el factor más importante y preponderante en la disminución del índice de riesgo de caries dental en las actuales generaciones. El presente artículo pretende hacer una narración histórica sobre los eventos más sobresalientes por los que pasó el trío de científicos en las Escuelas de Química y de Odontología de la Universidad de Indiana en sus respectivos campus de Bloomington e Indianápolis para lograr el desarrollo de la primera pasta dental con fluoruro. Más que un recuento histórico, la intención principal de este escrito es hacer una semblanza y un reconocimiento al trabajo del bioquímico Harry Day, quién trabajaba en su campo especializado sobre el valor nutricional de algunos elementos y que, junto con el trabajo del dentista Joseph C. Muhler y del especialista en Química inorgánica William Nebergall, logró producir un prototipo de pasta dental en el año de 1952 y que después de los excelentes resultados de los estudios clínicos liderados por Muhler tanto en niños como en adultos, llamaron la atención de Procter and Gamble para poder lanzar al mercado la primera pasta dental con Fluoristán, a la que se llamó Crest (AU)

It is always important to express some type of acknowledgement to people that were involved on leaving any form of legacy in our profession. As a personal view, the use of fluorides and specially the implementation of it in the formulation of toothpastes have been the key and preponderant factor in the decrease on the risk of dental caries in the current generations. This article pretends to be a historic narrative of the remarkable events in the group of the three scientists of the School of Chemistry and the School of Dentistry at both campuses of Bloomington and Indianapolis of Indiana University to fulfill the goal on the development of the first fluoridated toothpaste. More than a historical narrative, the main intention of this paper is to make a resemblance and an acknowledgement to the work of Biochemist Harry Day, who worked in his field of expertise on the nutrimental value of certain trace elements and that together with the work by dentist Joseph C. Muhler and the specialist in Inorganic Chemistry William Nebergall, could produced in year 1952 a prototype of a toothpaste that after several clinical studies in children and adults conducted by Muhler showed excellent results on caries prevention, and that took the attention of Procter and Gamble to be able to put on the market the first toothpaste with Fluoristan that was called Crest (AU)

Knowledge and Attitude of Parents of Preschool Children about Early Childhood Caries and Dental Caries Prevention / 대한소아치과학회지

To investigate knowledge and attitude of parents about early childhood caries and dental caries prevention, a questionnaire survey was conducted on 247 parents of children who had oral screening experience among 3 to 5 years old children in 3 kindergartens in Jeonju city.A total of 220 completed questionnaires were selected for final analysis. The overall perception of the parents about oral health of the children was 82.3 points (10.7 / 13) in terms of 100 points. There were statistically significant correlations between maternal age (p = 0.027), maternal education level (p = 0.002), household monthly income (p = 0.000) and maternal oral health knowledge level. The main source of oral health information was ‘dentist and dental hygienist’(83.6%) followed by ‘Web search’(22.3%).Compared with the previous studies, the level of knowledge of parents about oral health of the children was improved. However, in order to raise awareness of the parents about the poorly assessed items in this study, it is necessary to increase the participation rate by advertising the national dental screening program for infants and children and make efforts to improve the quality of oral health education in screening.

Caries prevention effectiveness of aresin based sealant and a glass ionomer sealants: a report of 5-year-follow-up / 中华口腔医学杂志

Objective@#To evaluate and compare the caries prevention effectiveness of a resin-based sealant and a glass ionomer sealant on permanent first molars in 7- to 9-years-old school children.@*Methods@#A randomized controlled, examiner-blinded, 5-year clinical trial was conducted in 19 primary schools in Dalian, Liaoning province. Totally 419 children (with 664 first molars) who had at least one sound permanent first molar with deep fissures or fissures with signs of non-cavitated lesions were recruited and stratified and allocated randomly into three parallel groups. A resin-based sealant was used in Group R (136 children with 219 first molars) and a glass ionomer sealant was used in Group G (130 children with 218 first molars). The third group (Group N, 153 children with 227 first molars) with none of the two sealants applied was served as blank control. Follow-up examinations were conducted at 0.5, 1, 2, and 5 years after sealing in order to assess the retention of the sealants and the incidence of caries occurrence. Chi-square test was adopted to compare the differences of caries incidence among the 3 groups. Generalized estimating equations (GEE) was used to analyze the effective factors of caries incidence.@*Results@#During the 5-year follow-up period, 13.4% (23/172) of the teeth in Group R, 22.5% (40/178) of the teeth in Group G and 34.5% (57/165) of the teeth in Group N were diagnosed as having developed cavitated lesions. And the differences in the incidence of caries among the three groups was statistically significant (P<0.05). According to GEE, the resin-based sealant and the glass ionomer sealant were found to be the protection factors and the non-cavitated lesion before sealing was found to be the risk factor. The resin-based sealant was found to be the protection factor to the glass ionomer sealant when the blank control group was removed.@*Conclusions@#Both resin-based sealant and glass ionomer sealant could effectively prevent the permanent first molars from the occurrence of carious lesions in 5 years. The resin-based sealant was superior to the glass ionomer sealant in caries prevention.

Caries and fluoridated water in two Brazilian municipalities with low prevalence of the disease / Cárie e água fluoretada em dois municípios brasileiros com baixa prevalência da doença

ABSTRACT OBJECTIVE To analyze the association between exposure to fluoridated water and dental caries in a context of widespread use of fluoride toothpaste in Brazil, in a scenario of low prevalence of the disease. METHODS This is a cross-sectional observational study, of the census type, in the form of a double population-based epidemiological survey carried out in two municipalities of the state of São Paulo in 2014. The sample consisted of adolescents aged 11 and 12 years, exposed (n = 184) or not exposed (n = 128) to fluoridated water for at least five years. The populations studied lived in communities of the same geographic region and had small demographic size and similar socioeconomic classification, differing only in the exposure (Silveiras) or not exposure (São José do Barreiro) to fluoridated water. The experience, magnitude, and degree of polarization of dental caries in these populations were analyzed using the DMFT and SiC indexes, and the association was tested using Pearson's chi-square statistics and prevalence ratio between those not exposed and those exposed to fluoridated water. RESULTS Although caries experience (DMFT ≥ 1) was not associated with exposure to fluoridated water (chi-square = 1.78; p = 0.18; α = 5%), a significant difference was observed in the magnitude with which the disease reached the population: the means of DMFT were 1.76 in those exposed and 2.60 in those not exposed and the means of SiC were 4.04 and 6.16, respectively. The degree of polarization, indicated by the percentage of subjects with DMFT = 0, was different, being it higher (41.8%) in subjects exposed and lower (34.3%) in subjects not exposed. The prevalence ratio between those not exposed and those exposed was 1.13, indicating little expressiveness in prevalence difference. CONCLUSIONS Exposure to fluoridated water implied lower mean values for the DMFT and SiC indexes, even in the presence of the concomitant exposure to fluoridated toothpaste, in a scenario of low prevalence of the disease, and with a similar pattern of caries distribution in the populations analyzed.

RESUMO OBJETIVO Analisar a associação entre a exposição à água fluoretada e cárie dentária, em contexto de uso generalizado de creme dental fluoretado no Brasil, em cenário de baixa prevalência da doença. MÉTODOS Realizado estudo observacional transversal, de tipo censitário, na modalidade de duplo inquérito epidemiológico populacional, em dois municípios paulistas em 2014. Participaram adolescentes de 11 e 12 anos, imersos na sua condição de exposição (n = 184) ou não exposição (n = 128) à água fluoretada, há pelo menos cinco anos. As populações avaliadas residiam em comunidades da mesma região geográfica, de pequeno porte demográfico e com classificação socioeconômica similar, diferenciando-se apenas pela condição de exposição à água fluoretada (Silveiras) e de não exposição (São José do Barreiro). A experiência, a magnitude e o grau de polarização da cárie dentária nessas populações foram analisadas por meio dos índices CPOD e SiC e a associação foi testada empregando-se as estatísticas qui-quadrado de Pearson e razão de prevalência entre não expostos e expostos à água fluoretada. RESULTADOS Embora a experiência de cárie (CPOD ≥ 1) não tenha se associado com a exposição à água fluoretada (qui-quadrado = 1,78; p = 0,18; α = 5%), observou-se expressiva diferença na magnitude com que a doença atingiu a população: as médias CPOD foram de 1,76 em expostos e 2,60 em não expostos e as médias SiC foram de 4,04 e 6,16, respectivamente. O grau da polarização, indicado pela porcentagem de indivíduos com CPOD = 0, foi diferente, maior (41,8%) em expostos e menor (34,3%) em não expostos. A razão de prevalência entre não expostos e expostos foi de 1,13, indicando pouca expressividade na diferença das prevalências. CONCLUSÕES A exposição à água fluoretada implicou menores valores médios dos índices CPOD e SiC, ainda que em presença de exposição concomitante a dentifrício fluoretado, em cenário de baixa prevalência da doença e padrão similar de distribuição de cárie nas populações analisadas.

Effects of a food enriched with probiotics on Streptococcus mutans and Lactobacillus spp. salivary counts in preschool children: a cluster randomized trial

Abstract Probiotics have provided benefits to general health, but they are still insufficient to dental health. Objective: This study aimed to evaluate milk supplemented with probiotic bacteria and standard milk, measured by levels of Streptococcus mutans (S. mutans) and Lactobacillus spp., in 3-4-year-old children after 9 months of intervention. Material and Methods: The study was a triple-blind, placebo-controlled, randomized trial. The sample was composed of 363 preschoolers attending five child development centers in Cali, Colombia. They were randomized to two groups: children in the intervention group drank 200 mL of milk with Lactobacillus rhamnosus 5x106 and Bifidobacteruim longum 3x106, and children in the control group drank 200 mL of standard milk. Interventions occurred on weekdays and information was gathered through scheduled clinical examination. The primary result was the number of colony forming units (CFU) of S. mutans and Lactobacillus spp. in the saliva. Secondary results were dental caries, rated by the International Caries Detection and Assessment System (ICDAS), dental plaque, pH, and salivary buffer capacity. Results: The proportion of S. mutans was lower in the intervention group compared with the control group after 9 months; however, the differences did not reach statistical significance (p=0.173); on the other hand, statistically significant differences between groups were found in the CFU/mL of Lactobacillus spp. (p=0.002). There was not statistically significant difference in the prevalence of dental caries for both groups (p=0.767). Differences between groups were found in the salivary buffering capacity (p=0.000); neither salivary pH nor dental plaque were significantly different. Conclusions: Regular consumption of milk containing probiotics bacteria reduced CFU/mL of Lactobacillus spp. and increased salivary buffering capacity at 9 months of consumption.

Clinical Application of Duraphat Fluoride Varnish / 昆明医科大学学报

Duraphat fluoride varnish is a topical coating material applied to tooth surfaces composed of fluoride compound,film-forming material and volatile solvent and containing 5％ sodium fluoride (22,600 ppm Fluoride).Many studies have shown the effectiveness of Duraphat fluoride varnishes in inhibiting caries,reducing tooth mineralization and releasing hypersensitive dentine.This article aims to review the research on clinical application of Duraphat fluoride varnish

Necessity to review the Brazilian regulation about fluoride toothpastes / Necessidade de revisão da regulamentação brasileira sobre dentifrícios fluoretados

The aim of this study was to evaluate the adequacy of the Brazilian legislation about fluoride toothpaste. A search was conducted in LILACS, Medline and SciELO databases about the fluoride concentration found in Brazilians toothpastes, using descriptors on health. Publications since 1981 have shown that some Brazilian toothpastes are not able to maintain, during their expiration time, a minimum of 1,000 ppm F of soluble fluoride in the formulation. However, the Brazilian regulation (ANVISA, Resolution 79, August 28, 2000) only sets the maximum total fluoride (0.15%; 1,500 ppm F) that a toothpaste may contain but not the minimum concentration of soluble fluoride that it should contain to have anticaries potential, which according to systematic reviews should be 1,000 ppm F. Therefore, the Brazilian regulation on fluoride toothpastes needs to be revised to assure the efficacy of those products for caries control.

O presente estudo analisou a adequação da regulamentação brasileira vigente sobre dentifrícios fluoretados. Foi realizada busca da literatura sobre a concentração de flúor nos dentifrícios brasileiros, tendo como fontes Lilacs, Medline e SciELO, com uso de descritores em saúde. Publicações sobre a composição de dentifrícios fluoretados brasileiros têm mostrado desde 1981 que nem todos os dentifrícios são capazes de manter durante o prazo de validade uma concentração mínima de 1.000 ppm F. Esse problema ocorre não só com dentifrícios adquiridos no mercado como com aqueles distribuídos por serviços públicos de saúde. Entretanto, a legislação brasileira (Resolução 79, Anvisa, 28/8/2000) apenas estabelece que um dentifrício não pode conter mais que 0,15% (1.500 ppm F) de flúor total, sem estabelecer o mínimo de flúor solúvel que ele deveria conter para ter potencial anticárie, a qual de acordo com revisões sistemáticas deve ser igual ou maior que 1.000 ppm F. Concluiu-se que a regulamentação brasileira sobre dentifrícios fluoretados necessita ser revisada, garantindo a eficácia desses produtos para o controle da cárie.

Multicentric caries prevention program: Mechanical control of dental plaque through periodic professional oral prophylaxis. A 10 years follow up

AIM: To verify the incidence of dental caries in a multicentric prevention program applied in pediatric dentistry clinics from different regions of Brazil for 10 years, and compare with results obtained by previous studies. MATERIAL AND METHODS: 697 children of both genders, ranging from 30 months to 15 years, were included in a primary preventive strategy program for mechanical control of dental plaque through professional prophylaxis (sodium bicarbonate jet on a monthly schedule). Diagnosis of carious lesions was assessed by monthly clinical examinations and annual radiographs. This procedure aimed to provide a biological equilibrium without producing undesirable side effects. RESULTS: The average age of children at beginning of the program was 81.71 months. Before entering the program the children presented an average of 2.66 lesions/surface, while during the program the average was 0.20 lesions/surface; the incidence rate of caries per year before starting the program was on average 0.62 lesions/surface while during the program it was 0.05 lesions/surface; the time of permanence in the program was on average 44.15 months and the absence rate was 0.14 per year. CONCLUSION: The results confirm the effectiveness of the program, even when applied by different professionals and in different groups of children, turning it into an indispensible method for the control of dental caries.

Mother’s knowledge and practice regarding oral Hygiene and challenges in the prevention of dental caries of under-five children in an urban resettlement colony.

Background: Dental carries is transmissible infectious disease and mother is the major primary source of infection for their children. Aims & Objective: To assess knowledge and practice of mothers of under-five children regarding dental caries. Material and Methods: 140 mothers having < 5 years old children selected through simple random sampling were interviewed using semi-structured schedule to assess the knowledge of oral health to prevent dental caries. Results: In the survey, 73.5% mothers knew about avoiding consumption of sweets/sweet fast foods/sugar beverages. A larger proportion of literate mothers were aware of regular cleaning of mouth, necessity of cleaning mouth after each feeding, sweets / sweet fast food & unclean mouth causes caries (p>0.05). They offers sweet/sweet fast food / sugar beverages more frequently, use toothpaste and brush for cleaning mouth for their children’s (p=0.010, p=0.008). A larger proportion of mothers who had an income > 3000 `/month were aware of sweets / sweet fast food & unclean mouth causes caries, necessity of regular cleaning after each feeding (p>0.05). But in spite of greater awareness of mothers a significantly lesser proportion of their children used toothpaste while brushing, do self-brushing and assisted brushing (p=00.007, 0.025, 0.022). An age group of >24 years and income > 3000 `/month were the predictors of good oral hygiene practice by mothers. Conclusion: Mothers of the study area had basic knowledge of caries prevention. However, their theoretical knowledge has been not fully reflected in the way they cared for their children's teeth.

In Vitro Enamel Remineralization by Low-Fluoride Toothpaste with Calcium Citrate and Sodium Trimetaphosphate

The objective of this study was to evaluate in vitro the effect of a low fluoride toothpaste (450 µgF/g, NaF) combined with calcium citrate (Cacit) and sodium trimetaphosphate (TMP) on enamel remineralization. Bovine enamel blocks had the enamel surface polished sequentially to determine the surface hardness. After production of artificial carious lesions, the blocks selected by their surface hardness were submitted to remineralization pH cycling and daily treatment with dentifrice suspensions (diluted in deionized water or artificial saliva): placebo, 275, 450, 550 and 1,100 µgF/g and commercial dentifrice (positive control, 1,100 µgF/g). Finally, the surface and cross-section hardness was determined for calculating the change of surface hardness (%SH) and mineral content (%∆Z). Fluoride in enamel was also determined. The data from %SH, %∆Z and fluoride were subjected to two-way analysis of variance followed by Student-Newman-Keuls's test (p<0.05). The mineral gain (%SH and %∆Z) was higher for toothpastes diluted in saliva (p<0.05), except for the 450 µgF/g dentifrice with Cacit/TMP (p>0.05). The 450 Cacit/TMP toothpaste and the positive control showed similar results (p>0.05) when diluted in water. A dose-response was observed between fluoride concentration in toothpastes and fluoride present in enamel, regardless of dilution. It was concluded that it is possible to enhance the remineralization capacity of low F concentration toothpaste by of organic (Cacit) and inorganic (TMP) compounds with affinity to hydroxyapatite.

O objetivo do presente trabalho foi avaliar in vitro o efeito de um dentifrício com reduzida concentração de fluoreto (450 µgF/g, NaF) associado ao citrato de cálcio (Cacit) e trimetafosfato de sódio (TMP) na remineralização do esmalte. Blocos de esmalte bovino tiveram sua superfície de esmalte polida seqüencialmente para determinação da dureza de superfície. Após o desenvolvimento de lesões artificiais de cárie, os blocos selecionados através da dureza de superfície foram submetidos a ciclagem de remineralização e tratamento diário com suspensões de dentifrícios (diluição em água deionizada ou saliva artificial): placebo, 275, 450, 550 e 1.100 µgF/g e com dentifrício comercial (controle positivo, 1.100 µgF/g). Ao término, determinou-se a dureza de superfície e em secção longitudinal, para cálculo da variação da dureza de superfície (%SH) e do conteúdo mineral (%∆Z). O fluoreto presente no esmalte também foi determinado. Os dados de %SH, %∆Z e fluoreto foram submetidos a análise de variância a dois critérios seguido pelo teste de Student-Newman-Keuls (p<0,05). O ganho mineral (%SH e %∆Z) foi maior para os dentifrícios diluídos em saliva (p<0,05), exceto para os dentifrícios 450 µg F/g com Cacit/TMP (p>0,05). Os dentifrícios 450 Cacit/TMP e controle positivo apresentaram resultados semelhantes (p>0,05) quando diluídos em água. Uma relação dose-resposta foi observada entre a concentração de fluoreto nos dentifrícios e o fluoreto presente no esmalte, independente da diluição. Concluiu-se que é possível melhorar a capacidade de remineralização de dentifrícios com reduzida concentração de fluoreto pela adição de compostos orgânico (Cacit) e inorgânico (TMP) com afinidade a hidroxiapatita.

Caries preventive effect of permanent teeth using pit and fissure sealant program and community water fluoridation program / 대한구강보건학회지

OBJECTIVES: The aim of this study was to evaluate the caries preventive effects of oral health programs composed of pit and fissure sealant and community water fluoridation in Hapcheon-Up, Hapcheon-Gun, the Republic of Korea. METHODS: Dental surveys were conducted on 6 to 14 year old children at Hapcheon-Up, Hapcheon-Gun in 2000 and 2009, respectively. The number of the subjects was 1,957 and 1,535 children in 2000 and 2009, respectively. The percentage of samples among total population aged 6 to 14 years in 2000 and 2009 was 90.6% and 92.3%, respectively. The obtained data from these surveys were analyzed with the PASW statistical package version 18.0 (SPSS Inc., Chicago, IL, USA). The 2009 dental health data including the prevalence of dental caries and fissure sealants on children's permanent teeth was compared to the 2000 dental health data, and assessed using chi-square test and independent-sample t-test. RESULTS: DMF rate of 12-year olds was 76.9% in 2000, and it significantly decreased to 42.5% in 2009. DMFT index of 12-year olds was 3.03 in 2000, and it significantly decreased to 1.07 in 2009. The prevalence rate of sealed permanent teeth among the 12-year olds was 15.4% in 2000, and it significantly increased to 97.2% in 2009. The caries reduction rate from pit and fissure sealant added by community water fluoridation program was calculated as 44.7% in 12-year olds by the difference of DMFT index between 2000 and 2009 year. Logistic regression analysis revealed that both programs were associated with an increasing likelihood of experiencing no dental caries (OR=4.00, 95% CI; 3.23-4.95). CONCLUSIONS: These results suggest that the oral health program composed of pit and fissure sealant and community water fluoridation in Hapcheon was very effective in caries prevention. The program should be expanded to other area to prevent dental caries among children.

Experiência de cárie dentária em crianças atendidas em um programa de Odontologia para bebês / Dental caries in children participating in a Dentistry for infants program

Objective: To assess the impact of the "Dentistry for Infants" early dental care program run by Jacareí County (SP) by comparing the caries of individuals participating and not participating in this program. Methods: In total, 300 children between 0 and 48 months old were assessed in the following two groups: infants not participating in the program (G1, n = 100) and infants participating in the program (G2, n = 200). Each group was further divided according to age in subgroups of 0 to 24 months and 25 to 48 months. All children were clinically assessed for carious lesions using the visual-tactile method. The data were statistically analyzed using a paired Student's t-test, Mann-Whitney test, and X² test at a 5% significance level. Results: There was a significant difference in the prevalence (P) and mean index of deciduous teeth (deft) (C) that were decayed, indicated for extraction and filled, and the highest values were observed in G1 (p < 0.0001). The values were as follows: PG1, 73%; PG2, 22%; CG1, 3.45 ± 3.84; and CG2, 0.66 ± 1.57. Conclusion: Participating in the program positively impacted the infants' oral health.

Objetivo: Avaliar o impacto na saúde bucal de crianças atendidas em um programa de atenção precoce "Odontologia para Bebês" da prefeitura do município de Jacareí (SP), por meio da comparação da experiência de cárie entre indivíduos participantes e não participantes do programa. Métodos: Foram avaliadas 300 crianças de 0 e 48 meses de idade, as quais foram divididas em 2 grupos: G1"Bebês não participantes do Programa" (n = 100) e G2 "Bebês do Programa" (n = 200). Cada grupo foi subdividido em dois, o primeiro com crianças de 0 a 24 meses, e o segundo de 25 a 48 meses. Todas as crianças receberam avaliação clínica quanto à presença de lesões de cárie (método táctil e visual). Os dados foram tabulados e analisados estatisticamente pelos testes t de Student pareado, Mann-Whitney e X², com nível de significância de 5%. Resultados: Houve diferença estatística para a prevalência (P) e o índice médio de dentes decíduos cariados, com extração indicada e obturados (ceod) (C), sendo os maiores valores observados para G1(p < 0,0001). Os valores foram: PG1 (73%), PG2 (22%), CG1 (3,45 ± 3,84), CG2 (0,66 ± 1,57). Conclusão: Concluiu-se que participar do programa interferiu positivamente na saúde bucal dos bebês.