Prácticas de salud bucal durante los primeros 1000 días de vida: Revisión de la literatura

Objetivo: Realizar una revisión bibliográfica de la literatura sobre las buenas prácticas en salud bucal, durante los primeros 1000 días de vida, el cual abarcó el periodo de gestación y los dos primeros años del niño. Materiales y métodos: Se realizó una revisión de la literatura científica desde febrero a marzo de 2022, para lo cual se utilizó las bases de datos Pubmed y Scopus. Los criterios de inclusión abarcaron artículos originales y revisiones sistemáticas (con o sin metanálisis) publicados entre 2016 y 2022. Se emplearon estrategias de búsqueda usando palabras clave, en inglés, derivadas del MeSH. Además, se revisó la literatura gris para definir algunos conceptos clave. Resultados: Se seleccionaron 72 artículos científicos y cuatro referencias de la literatura gris (una guía de práctica clínica y tres reportes). Los temas identificados se categorizaron en: buenas prácticas de higiene bucal, buenas prácticas de alimentación de la gestante y el infante, hábitos parafuncionales, y visitas al odontólogo. De acuerdo a los resultados, las recomendaciones clave para promover buenas prácticas de salud bucal durante este periodo crucial incluyen el uso de pasta dentífrica con flúor para la higiene dental una vez que erupcionan los dientes, evitar el consumo de azúcar libre, fomentar la lactancia materna en vez del uso del biberón y las visitas al odontólogo desde antes del nacimiento. Conclusión: Las buenas prácticas en salud bucal durante los primeros 1000 días de vida influyen significativamente en la salud oral y general del niño, por lo que es necesario adoptar medidas preventivas desde la gestación, enfocadas en la higiene oral y nutrición. La colaboración de un equipo de salud multidisciplinario, durante el embarazo y los dos primeros años de vida, es vital para mejorar la salud bucodental y general de la población.

Objective: To conduct a bibliographic literature review on current good practices in oral health during the first 1000 days of life, encompassing the gestation period and the initial two years of the child. Materials and methods:A scientific literature review was conducted in February and March 2022, utilizing the Pubmed and Scopus databases. The inclusion criteria encompassed original articles and systematic reviews (with or without meta-analysis) published between 2016 and 2022. Search strategies incorporating English keywords derived from MeSH were employed. Additionally, the grey literature was reviewed to define some key concepts. Results:72 scientific articles, and four references from the grey literature (one clinical practice guide and three reports) were selected. The identified themes were categorized as follows: good oral hygiene practices, good feeding practices for pregnant women and infants, parafunctional habits, and dental visits. Based on the findings, the key recommendations for promoting good oral health practices during this crucial period include the use of fluoride toothpaste for oral hygiene once teeth erupt, avoidance of free sugar consumption, encouragement of breastfeeding over bottle-feeding, and early dental visits before birth. Conclusion:Good oral health practices during the first 1000 days of life significantly impact the child's oral and general health, necessitating preventive measures starting from gestation, with a focus on oral hygiene and nutrition. The collaborative efforts of a multidisciplinary healthcare team during pregnancy and the initial two years of life are vital for enhancing both oral and general health outcomes for the population.

Efecto del tratamiento de la morfología oclusal con materiales para restauraciones preventivas / Effect of treating occlusal morphology with materials for preventive restorations

Introducción: las fosas y fisuras son áreas formadas por delgadas irregularidades de la capa del esmalte de la superficie oclusal. La compleja morfología en dientes posteriores es un determinante biológico asociado al desarrollo de caries. Objetivo: evaluar el efecto de diversas formas de tratar la morfología oclusal en la adaptación y penetración de materiales utilizados en restauraciones preventivas. Material y métodos: diseño experimental e in vitro. Sesenta terceros molares fueron distribuidos aleatoriamente en dos grupos: surco sin ameloplastia y con ameloplastia; además, contaban con acondicionamiento del esmalte que se subdividió en tres subgrupos: 1) sellador de fosas y fisuras, 2) adhesivo/sellador de fosas y fisuras y 3) adhesivo/ resina Flow. Resultados: los subgrupos adhesivo/sellador y adhesivo/ Flow alcanzaron mayores valores de adaptación íntima a las paredes del surco. Las diferencias fueron significativas entre los materiales (p = 0.0009). Las mayores zonas de desadaptación resultaron para el sellador sin y con ameloplastia. La penetración de los materiales fue mayor en los surcos con ameloplastia. En los surcos tratados con ameloplastia, el adhesivo/Flow reveló el mayor porcentaje de penetración y la mejor adaptación a las paredes del surco. Conclusiones: la penetración del material está positivamente correlacionada con la profundidad del surco. El sellador con y sin ameloplastia mostró pobre adaptación a las paredes del surco (AU)

Introduction: pits and fissures are areas formed by fine irregularities in the enamel layer of the occlusal surface. The complex morphology in posterior teeth are biological determinants associated with the development of caries. Objective: to evaluate the effect of various ways of treating occlusal morphology on the adaptation and penetration of materials used in preventive restorations. Material and methods: experimental design, in vitro. Sixty third molars were randomly distributed into two groups: groove without ameloplasty and with ameloplasty, with enamel conditioning with three subgroups: 1) pit and fissure sealer, 2) adhesive/pit and fissure sealer, 3) adhesive/resin flow. Results: the adhesive/sealant and adhesive/flow subgroups reached higher values of intimate adaptation to the furrow walls. The differences were significant between the materials (p = 0.0009). The largest areas of maladjustment were found for the sealant without and with ameloplasty. The penetration of the materials was greater in the grooves with ameloplasty. In the grooves treated with ameloplasty, the adhesive/flow revealed the highest percentage of penetration and the best adaptation to the walls of the groove. Conclusions: the penetration of the material is positively correlated with the depth of the furrow. The sealant with and without ameloplasty showed poor adaptation to the sulcus walls (AU)

Diferencias en el abordaje de dos premolares inferiores con dens evaginatus: reporte de caso / Diferencas na abordagem de dois pré-molares inferiores com dens evaginatus: relato de caso / Differences in the approach of two lower premolars with dens evaginatus: case report

El dens evaginatus es una anomalía dentaria de forma que consiste en una elevación del esmalte en forma de cúspide o tubérculo que se ubica en el surco central o en la zona bucal de las cúspides de premolares o molares, así como en las superficies palatinas de dientes anteriores. La estructura interna del tubérculo está formada por una capa de esmalte que recubre un núcleo de dentina el cual contiene, en el 90% de los casos una evaginación de tejido pulpar. En este artículo se reporta el caso de un paciente de ascendencia asiática con dos premolares inferiores con dens evaginatus las cuales fueron abordadas de diferente forma: una premolar recibió tratamiento preventivo y mínimamente invasivo mientras que la otra premolar requirió un tratamiento pulpar

Dens evaginatus é uma anormalidade dentaria que consiste em uma elevação do esmalte em forma de cúspide ou tubérculo que se localiza no sulco central ou na zona bucal das cúspides de pré-molares ou molares, bem como nas superficies palatinas dos dentes anteriores. A estructura interna do tubérculo é formada por uma camada de esmalte que recobre um núcleo de dentina que contém, em 90% dos casos, uma evaginação de tecido pulpar. Neste artigo relata o caso de um paciente de ascendência asiática com duas pré-molares inferiores com dens evaginatus, que foram abordados de forma diferente: um pré-molar recebeu tratamento preventivo e minimamente invasivo enquanto a outra pré-molar necessitou de tratamento pulpar

Dens evaginatus is a dental abnormality consisting of a cusp- or tubercle-shaped elevation of the enamel that is in the central groove or in the buccal area of the cusps of premolars or molars, as well as on the palatal surfaces of teeth. The internal structure of the tubercle is formed by a layer of enamel that covers a core of dentin which contains, in 90% of cases, an evagination of pulp tissue. This article reports the case of a patient of Asian descent with two lower premolars with dens evaginatus, which were approached differently: one premolar received preventive and minimally invasive treatment while the other premolar required root canal treatment.

Angina de Ludwig durante el embarazo. Reporte de caso / Ludwig's angina during pregnancy. Case report

RESUMEN Los cambios fisiológicos, hormonales e inmunes causados por el embarazo pueden predisponer a mayor riesgo de complicaciones infecciosas, en especial en infecciones odontogénicas. La angina de Ludwig es una complicación infecciosa rápidamente progresiva que afecta al suelo de la cavidad bucal, generalmente secundaria a abscesos de segundos y terceros molares mandibulares que posteriormente se extiende a los espacios submandibular, sublingual y submentoniano. Si no es tratada rápida y adecuadamente puede tener consecuencias mortales, como obstrucción de las vías aéreas altas y sepsis. Su aparición durante el embarazo está asociada a mayor riesgo de morbilidad perinatal severa, en la mayoría de los casos secundaria a hipoxia tisular. El tratamiento es la administración de antibióticos de amplio espectro y, en algunos casos, descompresión quirúrgica de las zonas afectadas. Pero es necesario considerar los potenciales efectos adversos fetales del manejo. Es fundamental reforzar la importancia de la buena salud bucodental de la embarazada para evitar esta complicación. Se presenta un caso de angina de Ludwig durante el embarazo.

ABSTRACT Physiological, hormonal and immune changes caused by pregnancy may predispose to increased risk of infectious complications, especially in odontogenic infections. Ludwig's angina is a rapidly progressive infectious complication affecting the floor of the oral cavity, usually secondary to abscesses of mandibular second and third molars that subsequently spreads to the submandibular, sublingual and submental spaces. If not treated quickly and adequately it can have fatal consequences, such as upper airway obstruction and sepsis. Its occurrence during pregnancy is associated with an increased risk of severe perinatal morbidity, in most cases secondary to tissue hypoxia. Treatment consists of the administration of broad-spectrum antibiotics and, in some cases, surgical decompression of the affected areas. But it is necessary to consider the potential adverse fetal effects of management. It is essential to reinforce the importance of good oral health of the pregnant woman to avoid this complication. A case of Ludwig's angina during pregnancy is presented.

Prevalence of malocclusion in early childhood and its associated factors in a primary care service in Brazil / Prevalência de maloclusões na primeira infância e fatores associados em um serviço de atenção primária no Brasil

ABSTRACT Purpose to evaluate the prevalence of malocclusion and its associated factors of children cared for by a PHC Service in Porto Alegre, Brazil. Methods a cross-sectional study nested in a cohort, carried out in 12 Health Care Practices. Of the 414 children in the cohort examined, 268 were assessed for malocclusion. The presence of anterior open bite, posterior and anterior crossbite was evaluated by the criteria of Foster and Hamilton. Socioeconomic variables, breastfeeding habits and pacifier use information were collected through a standardized questionnaire. Data analysis was performed using a hierarchical approach by Poisson Regression with robust variance. Results out of the total 268 evaluated, 135 (50.4%) were boys, and the average age was 28.6 (± 11.9) months. Out of the 143 (53.4%) cases of malocclusion, 113 were anterior open bite, 16 were anterior crossbite, 27 were posterior crossbite, and 38 had increased overjet. In the final analysis, it was observed that there was a higher prevalence of malocclusion in children who never breastfed (PR = 1.44; 95%CI 1.00-2.08) and who always used a pacifier to sleep (PR = 1.81; 95%CI 1.14-2.86). Conclusion the prevalence of malocclusion in this population was high and was associated with behavioral habits, such as the use of pacifier and not breastfeeding.

RESUMO Objetivo avaliar a prevalência de maloclusões e seus fatores associados em crianças atendidas em um Serviço de APS de Porto Alegre, Brasil. Método estudo transversal aninhado a uma coorte, realizado em 12 Unidades de Saúde. Das 414 crianças da coorte examinadas, 268 foram examinadas para maloclusão. A presença de mordida aberta anterior, mordida cruzada posterior e anterior foi avaliada pelos critérios de Foster e Hamilton. Variáveis socioeconômicas, hábitos de amamentação e informações sobre o uso de chupeta foram coletados por meio de questionário padronizado. A análise dos dados foi realizada por meio de uma abordagem hierárquica por Regressão de Poisson com variância robusta. Resultados do total de 268 avaliados, 135 (50,4%) eram meninos e a média de idade foi de 28,6 (± 11,9) meses. Dos 143 (53,4%) casos de maloclusão, 113 eram mordida aberta anterior, 16 eram mordida cruzada anterior, 27 eram mordida cruzada posterior e 38 tinham overjet acentuado. Na análise final, observou-se que houve maior prevalência de maloclusões em crianças que nunca foram amamentadas (RP = 1,44; IC95% 1,00-2,08) e que sempre usaram chupeta para dormir (RP = 1,81; IC95% 1,14 -2,86). Conclusão a prevalência de maloclusões nesta população foi elevada e esteve associada a hábitos comportamentais, como o uso de chupeta e a não amamentação.

Effectiveness and Legitimacy of the Motivational Interviewing With Caregivers on the Oral Health of Special Patients

ABSTRACT: Difficulty of caregivers in performing oral hygiene for Patients with Special Needs, usually leads to demotivation and negligence. In order to adhere to healthy habits, an intervention model was created: Motivational Interview (MI). It consists of a collaborative conversation to strengthen motivation and commitment to change. Objective: To evaluate the effectiveness and legitimacy of MI in a single session on the oral health of children with special needs, unable to perform the ir hygiene. Methods: Exploratory study with paired randomization, double-blind, including caregivers of patients aged 2 to 19 years treated at the Physical and Motor Rehabilitation Center of IMIP/Recife-Brazil. Caregivers were allocated to a test (Motiv ational Interview) or control (Traditional Counseling) group. In t0, they answered questionnaires, and the child's dental chart and Vis ible Plaque Index (VPI) were filled. MI group participated in a 10 min Motivational Interview involving guidance on brushing techniq ues and making mouth openers. TC group attended a lecture addressing the same theme. In t1, questionnaires were reapplied, followed by a new VPI and dental chart, in addition to a satisfaction survey regarding the methodology used. Results: After 30 days, the MI group showed a decrease in VPI when comparing the medians (14.70 vs. 10.71) and an increase in the frequency of daily brushing to 03 x or more (44.4 % vs. 77.8 %), while the TC group remained practically stable (8.75 vs. 10.71 and 28.6), but with no statistically significant difference between groups (p = 5 %). Both legitimized the workshop as a pleasurable activity (100 %) and felt motivated after completion (TC = 85.7 %, MI = 100 %). Conclusion: A single session of MI reduced VPI from disabled children, however, without proving to be more effective than Traditional Counseling.

RESUMEN: La dificultad de los cuidadores para realizar la higiene oral en pacientes con necesidades especiales, generalmente conduce a la desmotivación y negligencia. Con el objetivo de adherirse a los hábitos saludables, se creó un modelo de intervención a partir de una conversación colaborativa: Entrevista Motivacional (EM). El objetivo de este trabajo fue evaluar la eficacia y la legitimidad de la EM en la salud oral para los PNE infantiles. Estudio exploratorio con aleatorización pareada, doble ciego, que incluye cuidadores de pacientes de 2 a 19 años tratados en el Centro de Rehabilitación Física y Motora del IMIP/Recife- Brasil. Los cuidadores fueron asignados en dos grupos: prueba (Entrevista Motivacional - EM) y control (Consejería Tradicional - CT). En t0, se respondieron los cuestionarios y se realizó el Odontograma y el Índice de Placa Visible (IPV) del niño. Grupo EM participó en una entrevista motivacional de 10 minutos que incluyó orientación sobre las técnicas de cepillado y la apertura de la cavidad oral. Grupo CT asistió a una conferencia sobre el mismo tema. En t1, se volvieron a aplicar los cuestionarios, seguidos de una nueva IPV y un odontograma, además de una encuesta de satisfacción sobre la metodología utilizada. Después de 30 días, el grupo EM mostró una disminución en IPV al comparar las media- nas (14,70 vs. 10,71) y un aumento en la frecuencia diaria de cepillado a 03x o más (44,4 % vs. 77,8 %), mientras que el grupo CT permaneció prácticamente estable (8,75 vs. 8,92 y 28,6), pero sin diferencias estadísticamente significativas entre los grupos (p = 5 %). Ambos legitimaron el taller como una actividad placentera (100 %) y se sintieron motivados después de la finalización (AT = 85,7 %, EM = 100 %). Una sola sesión de EM redujo la IPV de las PNE, sin demostrar que es más efectiva que la asesoría tradicional.

Eficácia de óleos vegetais no controle do biofilme dental: revisão integrativa / Efficacy of vegetable oils in control of dental biofilm: integrative review / Eficacia de los aceites vegetales en el control de biofilm dental: revision integrativa

Introdução:A terapia de bochecho com óleos vegetais é uma cultura tradicional na Índia com intuito de prevenir afecções bucais, como cárie e doença periodontal. Atualmente, com as mudanças nos padrões alimentares da sociedade, tem-se empregado com maior valor o uso de óleos naturais, já que estudos demonstram sua importância para saúde.Objetivo:Esta revisão integrativa teve como objetivo selecionar evidências que mostrassem a utilização de óleos vegetais, com ação antimicrobiana, no controle do biofilme dental. Metodologia:O levantamento bibliográfico foi realizado nos meses de julho e agosto de 2020, por meio de pesquisa por via eletrônica, consultando-se o banco de dados Pubmed e SciELO (Scientific Electronic Library Online). Foram utilizados os descritores: Óleos vegetais, agentes antimicrobianos, Placa dental, Odontologia preventiva e Odontologia, os descritores foram usados separadamente e em cruzamento com o operador boleano AND. Utilizou-se os seguintes critérios de inclusão: Estudos clínicos, artigos completos e disponíveis gratuitamente, publicados no período de 2010 a 2020 em português e/ou inglês, e indexados nas bases de dados já citadas. Foram excluídos os trabalhos de conclusão de curso, dissertações, teses, livros e capítulos de livros, além de artigos duplicados e que não abordaram o tema do estudo.Resultados:Atenderam os critérios da pesquisa 04 estudos do tipo clínico randomizado, os quais mostraram eficiência dos óleos vegetais utilizados no controle do biofilme dental. A realização de pesquisas envolvendo e motivando a industrialização de produtos naturaiscontribui para a Política Nacional de Práticas Integrativas e Complementares.Conclusões:Os artigos analisados mostraram eficácia na utilização de óleos vegetais no controle do biofilme dental, sendo esses aplicados clinicamente,não mostrando prejuízo aos participantes e indicados como coadjuvante na manutenção da saúde bucal (AU).

Introduction:Mouthwash therapy with vegetable oils is a traditional culture in India with the aim of preventing oral diseases, such as caries and periodontal disease. Currently, with the changes in the dietary patterns of society, the use of natural oils has been used with greater value, since studies demonstrate its importance for health.Objective:This integrative review aimed to select evidence that showed the use of vegetable oils, with antimicrobial action, in the control of dental biofilm. Methodology:Thebibliographic survey was carried out in July and August 2020, through electronic research, consulting the Pubmed and SciELO database (Scientific Electronic Library Online). The descriptors were used: Vegetable oils, antimicrobial agents, dental plaque, preventive dentistry and dentistry, the descriptors were used separately and in cross-section with the Boolean operator AND. The following inclusion criteria were used: Clinical studies, complete and freely available articles, published between 2010 and 2020in Portuguese and / or English, and indexed in the databases already cited. Course completion papers, dissertations, theses, books and book chapters were excluded, as well as duplicate articles that did not address the subject of the study. Results:Four studies of randomized clinical type met the research criteria, which showed efficiency of vegetable oils used in the control of dental biofilm. Conducting research involving and motivating the industrialization of natural products contributes to the National Policy on Integrative and Complementary Practices.Conclusions:The analyzed articles showed efficacy in the use of vegetable oils in the control of dental biofilm, which were applied clinically without showing any harm to the participants and indicatedas an adjunct in maintaining oral health (AU).

Introducción: La terapia de enjuague bucal con aceites vegetales es una cultura tradicional en India con el objetivo de prevenir enfermedades bucales, como caries y enfermedad periodontal. Actualmente, con los cambios en los patrones dietéticos de la sociedad, se ha utilizado con mayor valor el uso de aceites naturales, ya que los estudios demuestran su importancia para la salud. Objetivo: Esta revisión integradora tuvo como objetivo seleccionar evidencias que mostraran el uso de aceites vegetales, con acción antimicrobiana, en el control del biofilm dental.Metodología: El relevamiento bibliográfico se realizó en julio y agosto de 2020, mediante investigación electrónica, consultando la base de datos Pubmed y SciELO (Scientific Electronic Library Online). Se utilizaron los descriptores: Aceites vegetales, agentes antimicrobianos, placa dental, odontología preventiva y odontología, los descriptores se utilizaron por separado y en corte transversal con el operador booleano AND. Se utilizaron los siguientes criterios de inclusión: Estudios clínicos, artículos completos y de libre acceso, publicados entre 2010 y 2020 en portugués y / o inglés, e indexados en las bases de datos ya citadas. Se excluyeron trabajos de finalización de curso, disertaciones, tesis, libros y capítulosde libros, así como artículos duplicados que no abordaran el tema de estudio. Resultados: Cuatro estudios de tipo clínico aleatorizado cumplieron con los criterios de investigación, los cuales mostraron la eficiencia de los aceites vegetales utilizados enel control del biofilm dental. Realizar investigaciones que involucren y motiven la industrialización de productos naturales contribuye a la Política Nacional de Prácticas Integrativas y Complementarias.Conclusiones: Los artículos analizados mostraron eficacia en el uso de aceites vegetales en el control del biofilm dental, los cuales fueron aplicados clínicamente sin mostrar daño a los participantes e indicados como coadyuvante en el mantenimiento de la salud bucal (AU).

Cárie Dentária: considerações clínicas e radiográficas para seu diagnóstico / Dental Caries: clinical and radiographic considerations for diagnosis

Introdução: O diagnóstico correto da cárie dentária é fundamental para o estabelecimento do seu tratamento. Ele pode ser realizado por diferentes métodos, os mais comuns são por meio da inspeção visual e do exame radiográfico. Objetivo: Discutir, a partir de uma revi-são de literatura, o diagnóstico clínico-radiográficoda doença cárie e a sua importância na instituição do tratamento correto para tal doença. Materiais e métodos: oi realizada uma revisão da literatura nas bases de dados eletrônicos: PubMed, BVS e Scielo, através do ras-treio de artigos relevantes publicados no período de Janeiro de 2015 à Junho 2020. Foram incluídos ainda na bibliografia selecionada 2 livros e 1 tese de doutorado, que fazem consi-derações relevantes sobre o assunto estudado. Resultados: Na inspeção visual, a apresen-tação da superfície dentária é bastante importante na determinação da atividade da lesão de cárie, devem ser considerados o aspecto, o brilho e a coloração da superfície dental para tal determinação. A radiografia é um complemento usado para auxiliar no diagnóstico forne-cendo mais visibilidade e detecção das lesões cariosas permitindo melhor visualização das superfícies proximais em dentes posteriores, auxiliando no diagnóstico das lesões nessas superfícies. Conclusão: O diagnóstico correto exige bastante conhecimento do examina-dor, pois manchas opacas presentes no esmalte nem sempre são lesões cariosas e podem refletir uma perda de mineral na estrutura desse tecido que se desenvolveu por diferentes causas, sendo elas pré ou pós-eruptivas. O diagnóstico precoce e preciso da cárie dentária é fundamental, pois essa doença ainda é a principal causa de perda dentária.

Introduction:The correct diagnosis of dental caries is fundamental for the establishment of its treatment. It can be carried out by different methods and the most common is through visual inspection and radiographic examination.Objective:to discuss, based on a litera-ture review, the clinical and radiographic diagnosis of caries disease and its importance in establishing the correct treatment for this disease.Materials and methods:a literature review was carried out on the electronic databases: PubMed, BVS and Scielo, by a search of relevant articles published from January 2015 to June 2020. Also, 2 books and 1 PhD thesis were included in the selected bibliography, since they bring relevant considerations on the subject studied.Results:In the visual inspection, the presentation of the dental sur-face is very important in determining the activity of the caries lesion, the aspect, the bri-ghtness, and the coloring of the dental surface must be considered for such determination. Radiography is a complement used to assist in diagnosis by providing more visibility and detection of carious lesions, allowing a better visualization of proximal surfaces in poste-rior teeth, helping in the diagnosis of lesions on these surfaces.Conclusion:The correct diagnosis requires a lot of knowledge from the examiner because opaque stains present in the enamel are not always carious lesions and can reflect a loss of mineral in the structure of this tissue that has developed for different causes, whether pre- or post-eruptive. Early and accurate diagnosis of tooth decay is essential, as this disease is still the main cause of tooth loss.

Cárie dentária: considerações clínicas e radiográficas para seu diagnóstico / Dental caries: clinical and radiographic considerations for diagnosis

Introdução: O diagnóstico correto da cárie dentária é fundamental para o estabelecimento do seu tratamento. Ele pode ser realizado por diferentes métodos, os mais comuns são por meio da inspeção visual e do exame radiográfico. Objetivo: Discutir, a partir de uma revi-são de literatura, o diagnóstico clínico-radiográficoda doença cárie e a sua importância na instituição do tratamento correto para tal doença. Materiais e métodos: oi realizada uma revisão da literatura nas bases de dados eletrônicos: PubMed, BVS e Scielo, através do ras-treio de artigos relevantes publicados no período de Janeiro de 2015 à Junho 2020. Foram incluídos ainda na bibliografia selecionada 2 livros e 1 tese de doutorado, que fazem consi-derações relevantes sobre o assunto estudado. Resultados: Na inspeção visual, a apresen-tação da superfície dentária é bastante importante na determinação da atividade da lesão de cárie, devem ser considerados o aspecto, o brilho e a coloração da superfície dental para tal determinação. A radiografia é um complemento usado para auxiliar no diagnóstico forne-cendo mais visibilidade e detecção das lesões cariosas permitindo melhor visualização das superfícies proximais em dentes posteriores, auxiliando no diagnóstico das lesões nessas superfícies. Conclusão: O diagnóstico correto exige bastante conhecimento do examina-dor, pois manchas opacas presentes no esmalte nem sempre são lesões cariosas e podem refletir uma perda de mineral na estrutura desse tecido que se desenvolveu por diferentes causas, sendo elas pré ou pós-eruptivas. O diagnóstico precoce e preciso da cárie dentária é fundamental, pois essa doença ainda é a principal causa de perda dentária.

Introduction:The correct diagnosis of dental caries is fundamental for the establishment of its treatment. It can be carried out by different methods and the most common is through visual inspection and radiographic examination.Objective:to discuss, based on a litera-ture review, the clinical and radiographic diagnosis of caries disease and its importance in establishing the correct treatment for this disease.Materials and methods:a literature review was carried out on the electronic databases: PubMed, BVS and Scielo, by a search of relevant articles published from January 2015 to June 2020. Also, 2 books and 1 PhD thesis were included in the selected bibliography, since they bring relevant considerations on the subject studied.Results:In the visual inspection, the presentation of the dental sur-face is very important in determining the activity of the caries lesion, the aspect, the bri-ghtness, and the coloring of the dental surface must be considered for such determination. Radiography is a complement used to assist in diagnosis by providing more visibility and detection of carious lesions, allowing a better visualization of proximal surfaces in poste-rior teeth, helping in the diagnosis of lesions on these surfaces.Conclusion:The correct diagnosis requires a lot of knowledge from the examiner because opaque stains present in the enamel are not always carious lesions and can reflect a loss of mineral in the structure of this tissue that has developed for different causes, whether pre- or post-eruptive. Early and accurate diagnosis of tooth decay is essential, as this disease is still the main cause of tooth loss.

Fisiopatologia da cárie dentária: entendendo o processo carioso / Physiopathology of the Dental Care: Understanding the Caries Process

Introdução: Cárie Dentária é o termo utilizado para caracterizar lesões em diferentes estágios de desenvolvimento. Estes processos patológicos ocorrem nas superfícies dos dentes por meses ou até anos. Objetivo: Explorar a fisiopatologia da cárie dentária, para que os cirurgiões-dentistas entendam o processo carioso e possam escolher a melhor terapêutica. Metodologia: O estudo caracterizou-se por um levantamento bibliográfico, utilizando-se de artigos científicos indexados na base de dados PubMED/Medline, publicados no período dos últimos 5 anos. Foram consultados 7.918 trabalhos e, destes, 21 foram selecionados após criteriosa filtragem. Resultados e discussão: As lesões cariosas são resultados de um desequilíbrio fisiológico entre o conteúdo mineral do dente e os fluidos da cavidade oral, em que ­ através de reações metabólicas ­ provocam a queda do pH, contribuindo para a desmineralização. A cárie pode comprometer o esmalte, dentina e/ou cemento, podendo progredir à total destruição do dente. Conclusões: Em virtude disso, a fisiopatologia da cárie dentária é um fenômeno estudado por décadas e cada vez mais se sabe sobre os processos envolvidos. Compreendê-los, portanto, permite aos profissionais da área um embasamento necessário para que se possa escolher o manejo terapêutico mais adequado para cada caso.

Introduction: Dental Caries is the term used to characterize lesions in different stages of development. These pathological processes occur on tooth surfaces for months or even years. Objective: To explore the pathophysiology of dental caries, so that dental surgeons understand the carious process and can choose the best therapy. Methodology: The study was characterized by a bibliographic survey, using scientific articles indexed in the PubMED / Medline database, published in the last 5 years. A total of 7,918 papers were consulted and 21 were selected after careful filtering. Results and discussion: Carious lesions are the result of a physiological imbalance between the mineral content of the tooth and the oral cavity fluids, which - through metabolic reactions - cause the pH to drop, contributing to demineralization. Caries can compromise enamel, dentin and / or cementum and may progress to complete tooth destruction. Conclusions: Because of this, the pathophysiology of dental caries is a phenomenon studied for decades and is increasingly known about the processes involved. Understanding them, therefore, allows professionals in the area to have the necessary background to choose the most appropriate therapeutic management for each case.

Salud bucodental para comunidades vulnerables y desplazadas de Popayán que viven en condiciones de pobreza / Dental health for Popayán´s vulnerable and displaced communities that live in poverty conditions

Introducción: En el Municipio de Popayán, departamento del Cauca, Colombia, hay más de 23 asentamientos, donde viven cerca de 4 mil personas desplazadas en condición de vulnerabilidad y pobreza, quienes, en su mayoría, no están protegidos por el del sistema de salud y carecen de atención odontológica. Objetivo: Aplicar los conocimientos sobre salud oral adquiridos en la carrera de odontología, para mejorar la salud bucodental en comunidades vulnerables y desplazadas que viven en condiciones de pobreza en Popayán, Cauca, Colombia. Método: Estudio cualitativo, tipo investigación acción. La población beneficiada se conformó por 1515 personas, a las que se le aplicaron procedimientos educativos, preventivos, curativos y restaurativos, durante 5 años. Resultados: La población más beneficiada fue la vulnerable; los más atendidos fueron: en cuanto a género. el femenino; rango de edad, niños entre 3 y 8 años y adultos, de 36 y más años. El procedimiento odontológico que más se realizó en niños fue la profilaxis dental y en adultos el raspaje supragingival. Conclusiones: Aplicar el currículo de la carrera de Odontología centrado en la promoción de salud y en el aprendizaje contextualizado a partir de su aplicación en virtud del desarrollo de la comunidad, lo convierte en un currículo con mayor compromiso social. Y la comunidad que recibe los beneficios se convierte en ente activo de los procesos de promoción de salud oral. La población vulnerable y la desplazada manifiestan receptividad ante los tratamientos clínicos orales que se le ofrecen(AU)

Introduction: In the municipality of Popayán, department of Cauca, Colombia, there are more than 23 settlements, where nearly 4000 displaced people live in conditions of vulnerability and poverty, most of whom are outside the health system and lack of dental care. Objective: To apply the knowledge on oral health according to the level of academic complexity acquired during Odontology major to improve dental health of vulnerable and displaced communities living in poverty conditions in Popayán, Cauca, Colombia. Methods: Qualitative study, research-action type. The beneficiary population was formed by 1,515 people who underwent educational, preventive, curative and restorative procedures during five years. Results: The most favored population was the vulnerable one; the most attended were: female gender; children in ages from 3 to 8 years old, and adults of 36 years old and over. The dental procedure that was carried out the most in children was dental prophylaxis, and supragingival scaling in adults. Conclusions: The appliance of Odontology major´s curriculum focused in health promotion and in the contextualized learning from its use towards the development of the community makes it an entity with bigger social commitment. The community that receives the benefits becomes an active body in the processes of dental health promotion. Vulnerable and displaced populations show receptiveness to the oral clinical treatments offered to them(AU)

Programa Educativo de salud bucodental en reclusos del Centro de Atención al Joven. Sancti Spíritus / Oral Health Education Program in inmates of the Youth Care Center. Sancti Spiritus

RESUMEN Fundamento: El insuficiente nivel de conocimiento sobre salud bucal, la presencia de factores de riesgos y las características propias de la juventud, son elementos determinantes que favorecen el desarrollo y aplicación de programas educativos. Objetivo: Evaluar la efectividad del Programa Educativo de salud bucodental en reclusos del Centro de Atención al Joven de la provincia Sancti Spíritus durante el período de enero a julio del 2017. Metodología: Se realizó un estudio cuasiexperimental de intervención comunitaria con diseño antes y después en un ambiente no controlado en una muestra de 42 reclusos de 18 a 25 años. El nivel de conocimiento se identificó a través de una encuesta, las prácticas a través de una entrevista estructurada y la eficiencia del cepillado bucodental mediante el control de placa dentobacteriana. Resultados: Se observó un cambio de 9.5 % a un 71.4 % del nivel de conocimiento bueno, al igual que en las prácticas y en la eficiencia del cepillado de un 31.0 % a un 83.3 %. Conclusiones: El Programa Educativo demostró su efectividad al obtener resultados satisfactorios en cuanto a la modificación de los conocimientos y prácticas sobre salud bucodental en los reclusos.

ABSTRACT Background: The insufficient level of knowledge about oral health, the presence of risk factors and the characteristics of youth, are determining elements that favor the development and application of educational programs. Objective: To evaluate the effectiveness of the Oral Health Education Program in inmates of the Youth Care Center in Sancti Spiritus province from January to July 2017. Methodology: A quasi-experimental study of community intervention with former and later design in an uncontrolled environment was designed, sample of 42 inmates aged 18 to 25. The level of knowledge was identified through a survey, practices through a structured interview and the efficiency of oral brushing through the control of dentobacterial plaque. Results: A change from 9.5 % to 71.4 % of good knowledge level was observed, as well as practices and brushing efficiency from 31.0 % to 83.3 %. Conclusions: The Education Program demonstrated its effectiveness by obtaining satisfactory results regarding the modification of knowledge and practices on oral health in inmates.

Oral health behaviors, dental injuries and mouthguard awareness among a sample of portuguese athletes: a cross sectional study / Comportamientos de salud bucal, lesiones dentales y conciencia del uso de protectores bucales entre una muestra de atletas portugueses: estudio transversal

Aim: To determine the oral health behaviors, the prevalence of dental injuries, the level of information about first-aid procedures in the case of dental avulsion and the mouthguard awareness in a sample of Portuguese athletes. Materials and Methods: Cross-sectional researchamong 1,048 athletes from the district of Viseu, Portugal. A self-administered questionnaire included demographic data and questions about: I) oral hygiene habits, II) occurrence of orofacial trauma, III) use of mouthguards and IV) athletes' knowledge regarding first-aid management in case of dental avulsion was given. The comparison between different variables was made by Chi-square test with level of significant set at p-value ≤0.05. Results: The mean age of the sample (76.24% male) was 18.14±8.17 years. Overall, the results demonstrated a low use of dental floss (25.48%) and a high number of athletes (21.94%) that had not visited a dentist in more than a year. The prevalence of dental trauma was 5.06% and the most common dental injuries experienced by athletes were crown fractures (60.38%). Nearly half of the participants (45.23%) reported not knowing how to act following a dental avulsion. The rate of mouthguard use was very low (9.73%). There was a significant relationship between the prevalence of dental injuries and the use of mouthguards (p=0.000; Cramér's V=0.145). Conclusion: The prevalence of dental trauma in our population was low. A low number of athletes use a mouthguard and there is a lack of knowledge concerning dental trauma issues. Prevention programs and promoting actions among this population are important and should be adopted.

Objetivo: Determinar los comportamientos de salud bucal, la prevalencia delesiones dentales, el nivel de información sobre los procedimientos de primeros auxilios en el caso de la avulsión dental y el conocimiento de los protectores bucales en una muestra de atletas portugueses. Materiales y métodos: estudio transversal de 1048 atletas del distrito de Viseu, Portugal. Se utilizó un cuestionario auto administrado que incluyó datos demográficos y preguntas sobre: I) hábitos de higiene bucal, II) ocurrencia de traumatismos orofaciales, III) uso de protectores bucales y IV) conocimiento de los atletas sobre el manejo de primeros auxilios en caso de avulsión dental. La comparación entre diferentes variables se realizó mediante la prueba de chi-cuadrado con el nivel de significancia establecido en p≤0.05. Resultados: La edad promedia de la muestra (76,24% hombres) fue de 18,14±8,17 años. En general, los resultados demostraron un bajo uso de hilo dental (25,48%) y un alto número de atletas (21,94%) que no habían visitado un dentista en más de un año. La prevalencia de trauma dental fue de 5,06% y las lesiones dentales más comunes que experimentaron los atletas fueron las fracturas de corona (60,38%). Casi la mitad de los participantes (45,23%) informaron que no sabían cómo actuar después de una avulsión dental. La tasa de uso de protectores bucales fue muy baja (9,73%). Hubo una relación significativa entre la prevalencia de lesiones dentales y el uso de protectores bucales (p=0,000; V de Cramer=0,145). Conclusión: la prevalencia de trauma dental en nuestra población fue baja. Un número bajo de atletas usa un protector bucal y hay una falta de conocimiento sobre temas de trauma dental. Programas de prevención y acciones de promoción entre esta población son importantes y deben ser adoptados.

Perfil demográfico y epidemiológico de pacientes con Hemofilia y von Willebrand atendidos en el Área de Estomatología del Hospital de Especialidades Carlos Andrade Marín / Demographic and epidemiological profile of patients with Hemophilia and von Willebrand treated in the Stomatology Area of the Carlos Andrade Marín Specialties Hospital

INTRODUCCIÓN. Las alteraciones hereditarias de la hemostasia son patologías raras, dentro de estas se encuentran: Hemofilia A, Hemofilia B y von Willebrand. La hemofilia es un trastorno hereditario, ligado al cromosoma X, causado por ausencia o actividad reducida del factor VIII o IX. La enfermedad de von Willebrand es causada por la deficiencia del factor VIII. OBJETIVO. Determinar el perfil demográfico y epidemiológico de pacientes con Hemofilia y von Willebrand. MATERIALES Y MÉTODOS. Estudio observacional, descriptivo, transversal. La población de estudio fueron 133719 con una muestra de 144 pacientes, los criterios de inclusión fueron: pacientes de ambos sexos entre 2 a 88 años de edad, con diagnóstico de Hemofilia A, B, von Willebrand. Atendidos en la consulta externa del Área de Estomatología del Hospital de Especialidades Carlos Andrade Marín, en el periodo 2015-2018. Datos obtenidos del sistema AS400, analizados en el programa International Business Machines Statistical Package for the Social Sciences, Versión 22.0. RESULTADOS. El 77,0% (111; 144) perteneció al género masculino. El rango de edad fue entre 23 y 33 años con 24,0% (34; 144). Tuvieron Hemofilia A 62,0% (93; 144); Hemofilia B 6,0% (9; 144); von Willerbrand 28,0% (42; 144). El 50,0% (77; 144) recibieron tratamientos odontológicos; preventivos 15,0% (21; 144) y curativos 13,0% (18; 144); siendo la mayor patología caries dental. CONCLUSIÓN. Se determinó el perfil demográfico y epidemiológico de los pacientes con Hemofilia y von Willebrand que permitió brindar un tratamiento integral, interdisciplinario y oportuno.

INTRODUCTION. Hereditary abnormalities of hemostasis are rare pathologies, within these are: Hemophilia A, Hemophilia B and von Willebrand. Hemophilia is an inherited disorder, linked to the X chromosome, caused by absence or reduced activity of factor VIII or IX. Von Willebrand's disease is caused by factor VIII deficiency. OBJECTIVE. Determine the demographic and epidemiological profile of patients with hemophilia and von Willebrand. MATERIALS AND METHODS. Observational, descriptive, cross-sectional study. The study population was 133719 with a sample of 144 patients, the inclusion criteria were: patients of both sexes between 2 and 88 years of age, with a diagnosis of Hemophilia A, B, von Willebrand. Attended in the external consultation of the Stomatology Area of the Carlos Andrade Marín Specialty Hospital, in the period 2015-2018. Data obtained from the AS400 system, analyzed in the International Business Machines Statistical Package for the Social Sciences program, Version 22.0. RESULTS 77,0% (111; 144) belonged to the male gender. The age range was between 23 and 33 years with 24,0% (34; 144). They had hemophilia at 62,0% (93; 144); Hemophilia B 6,0% (9; 144); von Willerbrand 28,0% (42; 144). 50,0% (77; 144) received dental treatments; preventive 15,0% (21; 144) and curative 13,0% (18; 144); being the biggest dental caries pathology. CONCLUSION. The demographic and epidemiological profile of patients with Hemophilia and von Willebrand was determined, which allowed to provide a comprehensive, interdisciplinary and timely treatment.

Actitudes y prácticas ante la búsqueda de atención odontológica en personas de la ciudad de México. Estudio cualitativo / Attitudes and practices toward dental health care searching among people of méxico city. qualitative study / Atitudes e práticas na busca por atendimento odontológico entre pessoas da Cidade do México. Estudo qualitativo

Antecedentes: La salud bucal es afectada por caries y enfermedad periodontal; ambas progresivas, irreversibles y cuyos efectos son acumulables con el tiempo. Sin embargo, son evitables cuando existen medidas preventivas y se busca la atención oportuna. Objetivo: Identificar las actitudes y prácticas que tienen las personas ante la búsqueda de atención odontológica. Métodos: Estudio cualitativo que identificó desde la subjetividad de los participantes, la experiencia y significado de la prevención y atención odontológicas; efectuado en 7 grupos focales con personas entre 18 y 60 años de edad. La muestra se definió por saturación teórica. Se diseñó y aplicó una guía semiestructurada para indagar sobre: Alternativas empleadas, búsqueda de atención, uso de los sistemas de salud y, experiencia de atención y salud bucal. Resultados: Se identificaron elementos que denotan ausencia de prevención. El dolor es referido como la principal manifestación de un problema y si éste es controlado, la búsqueda de atención se detiene. El sangrado de encía no es considerado relevante. Los procedimientos alternativos empleados antes de solicitar atención profesional son: automedicación, remedios caseros, consulta a empleados de farmacia y la internet. La búsqueda de atención se detuvo por: falta de tiempo y dinero, experiencias negativas previas (miedo, ansiedad), apatía, desidia y la pobre calidad de atención percibida en los servicios de salud. Conclusión: La falta de prevención está determinada por factores relacionados con el individuo y con el sistema de salud. La búsqueda de atención se hace con fines curativos o para reducir el daño resultante de consecuencias complejas y costosas en el tratamiento.

Background: Oral health is affected by caries and periodontal disease; both are progressive and irreversible, and the effects are cumulative with the passing of time. However, such effects are avoidable when preventive measures are taken along with timely care. Purpose: To identify the variables related to the absence of prevention and delay of dental care. Methods: Qualitative study conducted on seven focal groups of people between 18 and 60 years of age, to identify the experience and meaning of prevention and dental care. The sample was defined by theoretical saturation. A semi-structured guide was designed and applied to inquire about: options used, seeking care, use of health systems, and experience in the oral health care. Results: Absence of prevention was identified: feeling pain is the primary symptom of a problem; but if it is controlled, the search for care stops. Gingival bleeding is not considered as relevant. The alternative procedures used before requesting professional attention are self-medication, home remedies, consultation with pharmacy employees, or the internet. In such cases the search for dental care stopped by lack of time and money, negative experiences (fear or anxiety), apathy, indifference, and a poor-quality perception of health services. Conclusion: Lack of prevention is determined by factors related to the individual and the health system. A subsequent search for care with therapeutic purposes or damage limitation entails complex and costly consequences in treatments.

Antecedentes: A saúde bucal é afetada por cáries e doença periodontal; ambos são progressivos e irreversíveis, e os efeitos são cumulativos com o passar do tempo. No entanto, tais efeitos são evitáveis quando medidas preventivas são tomadas junto com o atendimento oportuno. Objetivo: Identificar as variáveis relacionadas à ausência de prevenção e demora no atendimento odontológico. Métodos: Estudo qualitativo, realizado em sete grupos focais de pessoas entre 18 e 60 anos, para identificar a experiência e o significado da prevenção e tratamento odontológico. A amostra foi definida por saturação teórica. Um roteiro semiestruturado foi elaborado e aplicado para indagar sobre: opções utilizadas, busca de assistência, uso de sistemas de saúde e experiência na atenção à saúde bucal. Resultados: Ausência de prevenção foi identificada: sentir dor é o principal sintoma de um problema; mas se for controlada, a busca por cuidados pára. O sangramento gengival não é considerado relevante. Os procedimentos alternativos utilizados antes de solicitar atenção profissional são: automedicação, remédios caseiros, consulta a funcionários de farmácia ou internet. Nesses casos, a busca por atendimento odontológico foi interrompida por falta de tempo e dinheiro, experiências negativas (medo ou ansiedade), apatia, indiferença e percepção de baixa qualidade dos serviços de saúde. Conclusão: A falta de prevenção é determinada por fatores relacionados ao indivíduo e ao sistema de saúde. Uma busca subsequente de cuidados com fins terapêuticos ou limitação de danos acarreta conseqüências complexas e onerosas nos tratamentos.

Efectividad a 3 y 6 meses de una intervención integral para caries dental en escolares de Sitio del Niño, La Libertad; San Cayetano Istepeque, San Vicente; Ilopango y Ciudad Delgado, San Salvador / Effectiveness at 3 and 6 months of an integral intervention for dental caries in schoolchildren from Sitio del Niño, La Libertad; San Cayetano Istepeque, San Vicente; Ilopango and Ciudad Delgado, San Salvador

El objetivo es determinar la efectividad a 3 y 6 meses de una intervención integral para caries dental en escolares de Sitio del Niño, La Libertad; San Cayetano Istepeque, San Vicente; Ilopango y Ciudad Delgado, San Salvador. Es una intervención comunitaria cuasi experimental con grupo control pre-post realizado en los niños de los centros escolares dentro de la cobertura de las Unidades Comunitarias de Salud Familiar, durante el período comprendido entre abril y diciembre de 2017 y primer trimestre del 2018, con una muestra total de 120 pacientes. Se realizó una evaluación diagnóstica para determinar las necesidades de tratamientos, registrándose los hallazgos en una ficha clínica. Se ejecutaron los tratamientos y posteriormente se determinó la efectividad a tres y seis meses con la disminución de la placa dentobacteriana, las lesiones de caries activas y la sobrevivencia de los tratamientos. El procesamiento y análisis de los datos se realizó en la herramienta informática S-DENT y SPSS. Al inicio de la investigación, se determinó una prevalencia de caries de 3.72; dando una disminución de caries de 0.91 a 3 meses y 0.58 a 6 meses. Así mismo, se evaluó el índice de higiene oral simplificado mostrando que el 40 % de la población estaba clasificada en nivel óptimo y a los 6 meses el porcentaje subió a 83%, con diferencia significativa p< 0.05. La supervivencia de sellantes de fosas y fisuras fue de 82% y de obturaciones fue de 92%. La intervención integral fue efectiva al disminuir el índice de placa dentobacteriana y de caries; así como el alto porcentaje de supervivencia de SFF y obturaciones.

The aim of the study is to determine the effectiveness at 3 and 6 months intervals of an integral intervention for dental caries in school children from Sitio del Niño, La Libertad; San Cayetano Istepeque, San Vicente; Ilopango and Ciudad Delgado, San Salvador. It is a quasy- experimental community intervention treatment with a pre-post control group, carried out among children of school centers within the coverage of the Family Health Community Units, between Apil and December of 2017 and the first trimester of 2018, with a total sample of 120 patients. A diagnostic evaluation was made to determine the necessities of treatments, and the findings were recorded in a clinical record card. The treatments were implemented and later their effectiveness was determined at three and six month intervals with the diminishing of the dento-bacterial plaque, active carious lesions and the survival of the treatments. The processing and analysis of the data were made using the S-DENT and SPDD Programs. At the beginning of the research, a dental caries prevalence of 3.72 was determined; resulting in a caries reduction of 0.91 at 3 months and 0.58 at six months. In the same way, the index of simplified oral hygiene was evaluated, showing that the 40% of the population was classified within the optimal level and in 6 months the percentage increased to 83%, with a significant difference of P< 0.05. The survival of the sealants of pits and fissures was the 82% and of the obturations was the 92%. The integral intervention was effective at decreasing the level of the dentobacterial plaque and caries; as well as the high percentage of survival of the SFFi and obturations.

Efectividad a 3 y 6 meses de una intervención integral para caries dental en escolares de Cacaopera, Morazán; Cojutepeque, Cuscatlán; Santiago Nonualco, La Paz; Apopa y Soyapango, San Salvador / Effectiveness at 3 and 6 months of a comprehensive intervention for dental caries in schoolchildren from Cacaopera, Morazán; Cojutepeque, Cuscatlán; Santiago Nonualco, La Paz; Apopa and Soyapango, San Salvador

Objetivo: Determinar la efectividad a 3 y 6 meses de una intervención integral de tratamientos para caries dental en dientes permanentes, en escolares de 9 a 11 años atendidos en 5 Unidades Comunitarias de Salud Familiar durante el año 2017. Metodología: El estudio es cuasi experimental de intervención comunitaria con grupo control pre y post en una muestra de 150 escolares, a quienes se les realizó un diagnóstico, tratamientos y sus respectivos controles para determinar la efectividad de la intervención integral. La fase de campo se realizó en el período de marzo de 2017 a febrero de 2018; el vaciado, análisis e interpretación de resultados se realizó en el Set de Diagnóstico, Experiencia y Necesidades de Tratamiento por Caries Dental (S-DENT) y el Paquete Estadístico Para Ciencias Sociales (SPSS). Resultados: El Índice Simplificado de Higiene Oral (ISHO) en el nivel óptimo inicial fue de 42%, a tres meses fue de 72.41% y a los seis meses fue de 85.71%; la supervivencia de sellantes de fosas y fisuras a los 6 meses fue de 53% y de obturaciones 86%; reportando una pérdida de seguimiento del 12.67%. Conclusión: La intervención integral fue efectiva, pues se logró disminución en cuanto a los niveles de índice de placa bacteriana, se redujo el promedio de caries dental y la supervivencia de tratamientos fue mayor al 50%.

Objective: To determine the effectiveness at 3 and 6 months of an integral intervention of treatment for dental cavities in permanent dentition, in school children aged 9 to 11, diagnosed in 5 Family Health Community Centers during the year 2017. Methodology: The study is quasi-experimental of community intervention with pre and post control group in a sample of 150 school children, who were not only diagnosed, but also given treatment, and their respective check-ups to determine the effectiveness of the integral intervention. The field phase was carried out from March 2017 to February 2018. Data were stored, analyzed, and interpreted using the Dental Caries Experience and Treatment Needs Diagnostic Set (S-DENT) and the Statistical Package for the Social Sciences (SPSS). Results: The Simplified Oral Hygiene Index (OHI-S) at the initial optimal level was 42%, at 3 months it was 72.41%, and at 6 months it was 85.71%; the survival of the pits and fissure sealants at 6 months was 53% and the survival of the fillings was 86% reporting a loss of follow-up of 12.67%. Conclusion: The integral intervention was effective, since it managed to decrease the index levels of the bacterial plaque, the average of dental cavities was reduced, and the treatment survival was greater than 50%.

Efectividad a 3 y 6 meses de una intervención integral para caries dental en escolares de Tepetitán, San Vicente; San Fernando y Nombre de Jesús, Chalatenango / Effectiveness at 3 and 6 months of a comprehensive intervention for dental caries in schoolchildren from Tepetitán, San Vicente; San Fernando and Name of Jesus, Chalatenango

Objetivo: Determinar la efectividad a 3 y 6 meses de una intervención integral para la prevención y tratamiento de caries en dientes permanentes, en escolares de 9 a 11 años con 11 meses, atendidos en tres Unidades Comunitarias de Salud Familiar (UCSF) el año 2017. MATERIALES Y MÉTODOS: El estudio efectuado es de tipo intervención comunitaria, cuasi experimental, con grupo control pre-post. Se intervinieron 1,664 superficies en un total de 90 individuos escolares, con un abordaje integral para la prevención y limitación de daño por caries dental, en la cual se realizó una fase higiénica; 125 remineralizaciones con flúor barniz, 737 sellantes de fosas y fisuras (SFF) y 196 obturaciones. RESULTADOS: Inicialmente, según el Índice de Higiene Oral Simplificado (ISHO), el 36.67% de los niños se encontró en categoría óptima, reportándose a los 3 meses el 90%, y el 82.67% a los 6 meses. Así mismo, al diagnóstico inicial, los niños presentaron una media de dientes afectados por caries de 4, reduciéndose a 1 a los 3 meses y de 0 a los 6 meses, siendo esta diferencia estadísticamente significativa (p<0.05). Según la prueba estadística, tuvieron una supervivencia para SFF del 95.05% a los 6 meses y de 34.27% a los 3 meses; mientras que para obturaciones, del 100% y 90%, respectivamente. CONCLUSIONES: La intervención fue efectiva para prevenir y limitar la caries dental, por la supervivencia de tratamientos, reducción de placa dentobacteriana y cálculo.

OBJECTIVE: To determine the effectiveness at 3 and 6 months of a comprehensive intervention for the prevention and treatment of dental caries in permanent teeth, in schoolchildren from 9 to 11 years 11 months old, attended in three Family Health Community Units (UCFS) in 2017. MATERIALS AND METHODS: The study conducted is a community intervention type, quasi-experimental with control pre-post group. It involved 1664 surfaces in a total of 90 schoolchildren individuals with a comprehensive approach to the prevention and limitation of damage by caries in which a hygienic phase was performed through 125 remineralizations with varnish fluoride, 737 fissure sealants (SFF) and 196 dental fillings. RESULTS: According to the Simplified Oral Hygiene Index (OHI-S), the 36.67% of the children were found initially in optimal category, reporting at 3 months the 90%, and the 82.67% at 6 months. Likewise, at the initial diagnosis children presented an average of teeth affected by caries of 4, reduced to 1 to 3 months and 0 at 6 months, this difference is statistically significant (p<0.05). According to the statistics test, there was a survival for fissure sealants of 95.05% at 6 months and 34.27% at 3 months; while for fillings it was of 100% and 90%, respectively. CONCLUSIONS: The intervention was effective to prevent and limit dental caries, according to the survival of treatments, reduction of dentobacterial plaque and dental calculus.

Efectividad a 3 y 6 meses de una intervención integral para caries dental en escolares de San Nicolás Lempa, San Vicente; Rosario de Mora, San Salvador; San Luis La Herradura, La Paz; Joateca y Torola, Morazán / Effectiveness at 3 and 6 months of a comprehensive intervention for dental caries in schoolchildren from San Nicolás Lempa, San Vicente; Rosario de Mora, San Salvador; San Luis La Herradura, La Paz; Joateca and Torola, Morazán

Objetivo: Determinar la efectividad a 3 y 6 meses de una intervención integral para caries dental de dientes permanentes en usuarios atendidos en las Unidades Comunitarias de Salud Familiar de San Nicolás Lempa en San Vicente; Rosario de Mora en San Salvador; San Luis La Herradura en La Paz; Joateca y Torola en Morazán. Metodología: Estudio tipo intervención comunitaria cuasi-experimental con grupo control pre-post; realizado en escolares usuarios de las Unidades Comunitarias de Salud Familiar; entre mayo del 2017 hasta abril del 2018, con una muestra total de 150 pacientes, clasificados según criterios de inclusión. Se realizó un diagnóstico inicial, tratamientos integrales y dos controles, los hallazgos fueron registrados en una guía de observación, para verificar la efectividad se utilizaron tablas de contingencia, ANOVA y Supervivencia. Resultados: Los tratamientos realizados en los escolares durante la investigación fueron, 150 técnicas de higiene bucal, 47 remineralizaciónes con barniz de flúor; 1,512 sellantes de fosas y fisuras (SFF), 232 obturaciones. El porcentaje de niños con un nivel óptimo de higiene oral fue ascendiendo de 41.33% inicial a un 84.56 a los 6 meses; el promedio de dientes permanentes cariados fue de 1.86 inicialmente, bajando a los 6 meses a 0.22; la supervivencia de sellantes de fosas y fisuras (SFF) fue de 89.34% y de las obturaciones 97%. Conclusión: La intervención integral con protocolos personalizados de educación, motivación y técnicas de higiene bucal, así como los tratamientos preventivos y curativos, fue efectiva, ya que permitió disminuir los niveles de placa bacteriana, cálculo dental y lesiones de caries; y también se observó la efectividad en la supervivencia de los SFF y de obturaciones.

Objective: To determine the effectiveness at 3 and 6 months of a comprehensive intervention for dental caries of permanent teeth in users treated at the Family Health Community Units of San Nicolás Lempa in San Vicente; Rosario de Mora in San Salvador; San Luis La Herradura in La Paz; Joateca and Torola in Morazán. Methodology: Cuasi-experimental community intervention study with pre-post control group carried out in school users of the Family Health Community Units between May 2017 and April 2018, with a total sample of 150 patients, classified according to inclusion criteria. An initial diagnosis, integral treatments and two controls were made, the findings were recorded in an observation guide. To verify the effectiveness, contingency, ANOVA and Survival tables were used. Results: The treatments carried out in the students during the research were 150 oral hygiene techniques, 47 remineralizations with fluoride varnish; 1,512 pits and fissure sealants, 232 seals. The percentage of children with an optimal level of oral hygiene was rising from an initial 41.33% to 84.56% at 6 months; the average of decayed permanent teeth was 1.86 initially, decreasing at 6 months to 0.22; the survival of pits and fissure sealants was 89.34% and the fillings 97%. Conclusion: The integral intervention with personalized protocols of education, motivation and oral hygiene techniques, as well as preventive and curative treatments was effective since it allowed to diminish the levels of bacterial plaque, dental calculus and caries lesions; also, the survival of pits and fissure sealants and obturations was observed. Key words: Comprehensive intervention, effectiveness, dental caries, dental treatments, oral hygiene techniques.

Conhecimento de gestantes sobre o teste da linguinha em neonatos / Knowledge of pregnant women about the neonatal tongue screening test

Introdução: O diagnóstico e o tratamento precoce de anquiloglossia em bebês favorece o desenvolvimento adequado das funções orofaciais. O conhecimento popular sobre o teste da linguinha (TL) pode disseminar sua realização. Objetivo: Verificar o conhecimento sobre o TL e sua relação com o perfil sociodemográfico de gestantes. Material e método: Foram investigadas 427 gestantes que realizaram o pré-natal em um hospital escola do sul do Brasil, no período de maio a dezembro de 2017. As informações foram obtidas por meio de questionário individual contendo perguntas sobre as características sociais, demográficas e gestacionais da gestante, e o conhecimento sobre o teste da linguinha. Os dados foram analisados por estatística descritiva e as associações realizadas com o teste qui-quadrado. Resultado: Os resultados demonstraram que 33 (7,7%) gestantes conhecem e 45 (10,5%) possuem informações equivocadas sobre o TL. Gestantes com grau de escolaridade (p=0,028) e renda familiar (p=0,002) maiores são mais propensas a conhecer o teste. Profissionais da enfermagem são os principais provedores da informação (64,1%). Conclusão: O conhecimento de gestantes sobre o TL é superficial, especialmente entre as de menor escolaridade e renda, o que acentua a necessidade de estratégias públicas com foco em melhorar a qualidade da assistência oferecida ao binômio mãe-filho.

Introduction: The early diagnosis and treatment of ankyloglossia in infants favors the adequate development of orofacial functions. The knowledge about the tongue screening test (TL) may disseminate its realization. Objective: The aim of this study was to verify the knowledge about the neonatal tongue screening test (TL) and its relation with the sociodemographic profile of pregnant women. Materials and method: A total of 427 pregnant women receiving prenatal care at a school hospital in southern Brazil from May to December 2017 were investigated. The information was collected through an individual questionnaire containing information about the pregnant woman's sociodemographic profile and gestational characteristics and knowledge about the TL. Data were analyzed by descriptive statistics and the associations performed with the chi-square test. Result: The results showed that 33 (7.7%) of the pregnant women knew and 45 (10.5%) had misinformation about the TL. Pregnant women with higher education (p=0.028) and higher family income (p=0.002) were more likely to know the test. Nursing professionals were the main providers of the information (64.1%). Conclusion: It is possible to conclude that the knowledge of pregnant women about the TL is superficial, especially among those with lower schooling and income, and it emphasizes the need for public strategies focused on improving health care offered to the mother-baby binomial.