Relationship of Dental Caries and Body Mass Index amongst School Children in Hail, Saudi Arabia: A Cross-Sectional Study

ABSTRACT Objective: To determine caries prevalence and its association with body mass index in school children between 9-12 years of age in Hail, Saudi Arabia. Material and Methods: This descriptive cross-sectional study included 524 school children 9-12 years of age. These children were selected from 9 Public schools in Hail Province. Dental caries was recorded as per criteria established by the World Health Organization using assessment form for children 2013. Children were weighed using an electronic scale nearest to 0.1 kg with children attired in light clothing and wearing no shoes. The height was measured using a stadiometer to the nearest full centimeter with the children in a standing position. Body Mass Index (BMI) was determined using the formula BMI = kg/m2. Results: Caries prevalence in the population was 86%. The comparisons of mean DMFT between the groups demonstrate higher scores in the overweight group (mean=2.43) compared to normal weight (mean=1.85) and underweight children (mean=1.56) which is statistically significant (p=0.000). Bonferroni Post hoc test to compare the underweight and overweight group (p=0.000) and overweight and normal weight (p=0.000) were highly significant. Conclusion: A positive correlation of caries severity, namely DMFT, with BMI is established.

Importância da abordagem integral da cárie na primeira infância / Importance of integral approach of caries in early childhood

Introdução: a cárie na primeira infância (CPI), refere-se à patologia encontrada na dentição decídua em crianças com idade inferior a 71 meses. Apesar de avanços significativos na educação em saúde bucal, a CPI continua a afetar um número exacerbado de crianças em todo o mundo. Objetivo: revisar a literatura ressaltando a abordagem integral da lesão de cárie em crianças na primeira infância, levantando e discutindo a etiologia, os principais fatores de risco interrelacionados no surgimento da cárie, buscando informações necessárias para orientação aos cuidadores. Fonte dos dados: foram captados dados da Organização Mundial da Saúde e artigos em português e inglês que abordassem a cárie na primeira infância levando em consideração toda sua abordagem, nas bases de dados Biblioteca Virtual em Saúde, Scielo e PubMed, no período de 2009 a 2020. Síntese dos dados: verificou-se que a cárie na primeira infância é uma doença evitável, caso haja priorização da promoção de saúde e meios de prevenção desde os primeiros anos da criança. Os principais fatores de risco da doença são: a dieta cariogênica, o nível socioeconômico, escolaridade dos responsáveis, baixo contato com fluoretos e falta de higienização bucal correta. Conclusão: o estudo dos fatores envolvidos no surgimento da CPI é relevante, uma vez que reconhecendo-os pode-se buscar meios estratégicos de diminuir a incidência dessa doença que causa tantas consequências. Percebeu-se que a orientação dos cuidadores é um dos principais meios de preveni-la ou trata-la precocemente evitando maiores danos na dentição.

Introduction: early childhood caries (ECC) refers to the pathology found in primary dentition in children under 71 months of age. Despite significant advances in oral health education, ECC continues to affect an exacerbated number of children around the world. Objective: to review the literature emphasizing the integral approach of caries lesions in children in early childhood, pointing and discussing the etiology, the main interrelated risk factors in the onset of caries, pursuing necessary information to guide caregivers. Sources of data: were collected data from World Health Organization and articles in Portuguese and English that approached entirely the caries in early childhood, in the Virtual Health Library, Scielo and PubMed databases, from 2009 to 2020. Synthesis of data: caries in early childhood, as verified is a preventable disease if health promotion and ways of prevention are taking as a priority since the child's early years of old. The main risk factors of the disease are: the cariogenic diet, the socioeconomic level, education of those responsible for the child, low contact with fluorides and lack of correct oral hygiene. Conclusion: the study of the factors involved in the development of ECC is relevant, since recognizing it, is possible to seek strategic ways to reduce the incidence of this disease that causes so many consequences. It was noticed that the guidance of caregivers is one of the main ways to prevent or treat it early, avoiding further damage to the dentition.

Fatores comportamentais e socioeconômicos são fortes preditores de cárie dentária em pré- escolares: um estudo transversal / Behavioral and socioeconomic factors are strong predictors of dental caries in preschoolers: a cross-sectional study

Avaliaram-se possíveis preditores para a cárie dentária em pré-escolares sem experiência odontológica prévia, que buscaram a clínica de odontopediatria de uma universidade pública. Analisaram-se 191 prontuários, dos quais 87 foram incluídos. Coletaram-se dados demográficos, socioeconômicos, histórico de cárie da mãe, orientação prévia sobre cárie, frequência de escovação, uso de dentifrício fluoretado, consumo de doces/biscoitos e/ou líquidos açucarados, ceo-d e a presença ou ausência de defeitos de desenvolvimento do esmalte. Análises descritivas e de regressão logística binária foram realizadas para investigar quais variáveis prediziam um ceod>0. O modelo múltiplo incluiu consumo de doces/biscoitos, dados socioeconômicos, histórico de cárie na mãe e orientação prévia sobre cárie. Das crianças (2,69±1,18 anos), a maioria (67,8%) apresentava ceod>0 (3,78±3,82), sendo 50,6% meninas e 73,3% da classe baixa. A maioria (56,5%) das mães tinha 12 anos de estudos completos, histórico de cárie (78,6%) e receberam orientação prévia sobre cárie (52,9%). A maior parte (80,6%) escova os dentes pelo menos 2 vezes ao dia, utiliza dentifrício fluoretado (75,9%) e consome líquidos açucarados (90,8%), além de doces/biscoitos (86,9%) entre as refeições. Pertencer à classe baixa aumentou em 7 vezes a chance de ceod>0 (OR=7,354; IC 95%=1,951-27,723), histórico de cárie na mãe em 4 vezes (OR=4,131; IC 95%=1,042-16,369) e consumo de doces/biscoitos em quase 2 vezes (OR=1,786; IC 95%=1,072-2,976). Classe econômica baixa, histórico de cárie da mãe e consumo de doces/biscoitos entre as refeições mostraram-se fatores associados ao ceod>0 nos pacientes sem experiência prévia odontológica de uma clínica de odontopediatria de uma universidade pública.

Possible predictors of dental caries in preschool children without previous dental experience, who sought a pediatric dentistry clinic at a public university, were evaluated. Medical records (n=191) were analyzed; 87 were included. Demographic, socioeconomic data, mother's history of caries, previous orientation on caries, brushing frequency, use of fluoridated toothpaste, consumption of sweets/cookies and/or sugary liquids, dmft and the presence or absence of enamel development defects were collected. Descriptive and binary logistic regression analyzes were performed to investigate which variables predicted a dmft>0. The multiple model included consumption of sweets/cookies, socioeconomic data, mother's history of caries and previous orientation on caries. Of the children (2.69±1.18 years), most (67.8%) had dmft>0 (3.78±3.82), with 50.6% girls and 73.3% from the lower class. Most mothers had completed 12 years of schooling (56.5%), reported history of caries (78.6%) and received previous orientation on caries (52.9%). Most of children brush their teeth at least twice a day (80.6%), use fluoridated toothpaste (75.9%) and consume sugary liquids (90.8%), in addition to consumption of sweets/cookies (86 .9%) among the meals. Belonging to the lower class increased the chance of having dmft>0 by 7 times (OR=7,354; 95% CI=1,951-27,723), mother's history of caries by 4 times (OR=4,131;95% CI=1,042-16,369) and consumption of sweets/cookies by almost twice (OR=1,786;95% CI=1,072-2,976). Low economic class, mother's history of caries and consumption of sweets/cookies between meals were factors associated with dmft>0 in the patients without previous dental experience in a pediatric dentistry clinic at a public university.

Cárie na primeira infância: um problema de saúde pública global e suas consequências à saúde da criança / Caries in early childhood: a global public health problem and its consequences to children's health

Esse estudo tem como objetivo realizar uma revisão de literatura para apresentar os efeitos da doença cárie em crianças e ressaltar a importância do acompanhamento familiar. Foram selecionados artigos de 2011-2021, publicados nas bases de dados PubMed e SciELO utilizando os descritores: Doença cárie, Prevenção, Odontopediatria, foram incluídos artigos que estavam disponíveis na íntegra em português e inglês. A cárie dental continua a ser um problema de saúde pública, com maior prevalência em crianças e caracterizada por ser uma doença de etiologia multifatorial, biofilme-açúcar dependente não transmissível. A cárie de primeira infância (CPI) é capaz de afetar negativamente a qualidade de vida, por se apresentar como rápido desgaste da estrutura dental e presença de sintomatologia dolorosa. Isso pode resultar em um quadro de perda precoce, má oclusão, prejudicando a mastigação, dentição permanente, sono, rendimento escolar, favorecendo a desnutrição e afetando desenvolvimento. A Declaração de Bangkok recomenda aumento de conscientização sobre essa doença através da educação dos pais, limitação na ingestão de açúcar até os 2 anos de idade e escovação dos dentes de pelo menos 2x/ dia com dentifrício fluoretado. Diante do exposto, se torna essencial o acompanhamento da saúde odontológica da criança desde a erupção do primeiro dente na cavidade bucal, visando reduzir a CPI e contribuir para uma melhor qualidade de vida.

This study aims to carry out a literature review to present the effects of caries disease in children and emphasize the importance of family monitoring. Articles from 2011-2021 were selected, published in the PubMed and SciELO databases using the descriptors: Caries Disease, Prevention, Pediatric Dentistry, articles that were available in full in Portuguese and English were included. Dental caries continues to be a public health problem, with greater prevalence in children and characterized by being a disease of multifactorial etiology, non-transmissible biofilm-sugar dependent. Early childhood caries (CPI) is capable of negatively affecting the quality of life, as it presents itself as a rapid wear of the tooth structure and the presence of painful symptoms. This can result in early loss, malocclusion, impairing chewing, permanent dentition, sleep, school performance, favoring malnutrition and affecting development. The Bangkok Declaration recommends raising awareness of this disease through parent education, limiting sugar intake until age 2, and brushing teeth at least twice a day with fluoride toothpaste. Given the above, it is essential to monitor the child's dental health from the eruption of the first tooth in the oral cavity, in order to reduce CPI and contribute to a better quality of life.

Principales alimentos con azúcares añadidos y su variación geográfica y sociodemográfica: estudio latinoamericano de nutrición y salud (ELANS) / Main foods with added sugars and their geographic and sociodemographic variation: Latin American study of nutrition and health (ELANS)

Diversos estudios epidemiológicos y de intervención apuntan a una asociación fuerte y consistente entre la ingesta excesiva de azúcares y el riesgo de desarrollar caries dentales y enfermedades crónicas no transmisibles. El objetivo fue describir los 10 principales alimentos que contribuyen a la ingesta de azúcares añadidos en muestras representativas de poblaciones urbanas de ocho países latinoamericanos, y considerar diferencias por país, sexo, nivel socioeconómico (NSE) y grupo de edad. Se realizó una encuesta transversal multinacional en hogares de Argentina, Brasil, Chile, Colombia, Costa Rica, Ecuador, Perú y Venezuela (N=9218; 15­65 años). La contribución porcentual a la ingesta total del nutriente sirvió para identificar los alimentos aportadores. Los datos se estratificaron por país, sexo, NSE y grupo de edad y se compararon los gramos por día. Excepto en Perú y en el grupo de 50 a 65 años, los refrescos figuraron como el principal contribuyente a la ingesta de azúcares añadidos. Las bebidas caseras y las industrializadas también destacaron. Argentina fue el país con mayor ingesta de azúcares añadidos aportados por bebidas industrializadas, y Chile el país con menor frecuencia de bebidas como fuentes. Entre los 10 contribuyentes, la ingesta de azúcares añadidos fue mayor en el sexo masculino, excepto para sacarosa y pasteles dulces. Mayores ingestas de azúcares provenientes del jugo de fruta natural y sacarosa fueron observadas en el NSE más bajo. Las mayores y menores ingestas en los grupos de edad cambian de acuerdo con la fuente alimentaria. En conclusión, las bebidas azucaradas fueron los principales contribuyentes a la ingesta de azúcares añadidos, y la ingesta varió según la ubicación geográfica y los factores sociodemográficos(AU)

This study aimed to describe the top 10 foods that contribute to added sugars intake in representative samples of urban populations in eight Latin American countries, and consider differences by country, sex, socioeconomic level (SEL), and age group. A household-based, multinational, cross-sectional survey was conducted in Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (N=9218; 15­65 years). Contributors to added sugars were identified and listed based on the percentage of contribution to total intake of this nutrient. Data were stratified by country, sex, SEL, and age group, and the grams per day compared. Except in Peru and in the 50 to 65 years age group, soft drinks were the leading contributor to added sugar intake. Homemade beverages together industrialized beverages have been a prominent position on ranking. In general, the highest intake of added sugars by industrialized beverages was from Argentina, and the lowest frequency of beverages as sources of added sugars was observed in Chile. Among the top 10 contributors, male sex had highest added sugar intake, except for sucrose and sweet cakes. Higher intakes of sugars from natural fruit juice and sucrose were observed in the lower SEL. The highest and lowest intakes in the age groups change according to the food source. In conclusion, sugar-sweetened beverages were main contributors to added sugar intake, and the intake vary with geographical location and sociodemographic factors(AU)

Caries en niños. ¿Maltrato infantil o ignorancia parental? / Caries in children. Child abuse or parental ignorance?

El maltrato infantil es un tema polémico en la actualidad, y se caracteriza por realizar acciones u omisiones intencionales destinadas a menoscabar o afectar la integridad física y/o psicológica de un menor. Frecuentemente se considera a la caries en niños como un indicador objetivo de maltrato infantil. La caries es una enfermedad extremadamente común en la población infantil en México y en el mundo, por lo que su relación con el maltrato infantil carece de un sustento real. El desarrollo de caries en niños no es un evento premeditado ni intencional, es más bien la consecuencia de malos hábitos higiénicos y dietéticos que el odontólogo tiene la obligación de corregir y erradicar para asistir a los pacientes pediátricos a recuperar su salud bucodental. El objetivo del presente artículo es debatir la relación entre la caries temprana de la infancia y el maltrato infantil (AU)

Child abuse is currently a controversial issue and is characterized by intentional actions or omissions intended to undermine the physical and/or psychological integrity of a minor. Caries in children is often considered an objective indicator of child abuse. Caries is an extremely common disease in the child population in Mexico and in the world, so its relationship with child abuse lacks any real support. The development of cavities in children is not a premeditated or intentional event, it is rather the consequence of poor hygienic and dietary habits that the dentist has the obligation to correct and eradicate in order to assist pediatric patients to regain their oral health. The aim of this article is to discuss the relationship between early childhood caries and child abuse (AU)

Iniquidades socioeconômicas na saúde bucal de estudantes universitários do sul do Brasil / Socioeconomic inequities in the oral health of university students in southern Brazi

Objetivo: Identificar a magnitude da associação entre experiência de cárie dentária e autopercepção negativa de saúde bucal com determinantes socioeconômicos. Métodos: Estudo transversal realizado com dados de uma coorte prospectiva com os universitários ingressantes na Universidade Federal de Pelotas (UFPel) no ano de 2016. Os dados foram coletados por meio de questionário autoaplicável, incluindo características demográficas, socioeconômicas e psicossociais. Os desfechos do presente estudo foram a experiência de cárie autorrelatada (histórico de doença cárie) e autopercepção de saúde bucal (positiva versus negativa). Resultados: Um total de 3.237 alunos ingressou, dos quais 2.089 (64,5%) concordaram em participar do estudo. O modelo de regressão de Poisson mostrou que universitários com renda familiar de R$ 1001,00 a 5000,00 e R$ 5001,00 ou mais apresentaram, respectivamente, uma razão de prevalência (RP) 14% (RP = 0,86; IC95% 0,80-0,92) e 18% (RP = 0,82; IC95% 0,74 a 0,90) menor de experiência de cárie, assim como indivíduos cujas mães tinham ensino médio completo apresentaram uma prevalência 14% menor (RP = 0,86; IC95% 0,80 a 0,92) e ensino superior completo 19% (RP = 0,81; IC95% 0,75 a 0,87) menor de experiência de cárie, quando comparados aos grupos de referência. Na autopercepção de saúde bucal, os resultados para renda familiar de R$1001 a 5000,00 e R$ 5001 ou mais apresentaram, respectivamente, uma prevalência 23% (RP = 0,77; IC95% 0,64 a 0,91) e 43% (RP = 0,57; IC95% 0,45 a 0,72) menor de ter autopercepção de saúde bucal negativa e indivíduos cujas mães tinham ensino superior completo reportaram uma prevalência 21% menor de autopercepção de saúde bucal negativa quando comparados à referência (RP = 0,79; IC95% 0,66 a 0,97). Conclusões: Os achados do presente estudo confirmam que os indicadores socioeconômicos influenciam a experiência de cárie autorrelatada e a autopercepção de saúde bucal dos universitários.

Objective: To identify the magnitude of the association between dental caries experience and negative self-per-ception of oral health with socioeconomic determinants. Methods: Cross-sectional study conducted with data from a prospective cohort with university students entering the Federal University of Pelotas (UFPel) in 2016. Data were collected through a self-administered questionnaire, including demographic, socioeconomic and psychosocial characteristics. The outcomes of the present study were experience of self-reported caries (history of caries disease) and self-perceived oral health (positive versus negative). Results: A total of 3,237 students joined, of which 2,089 (64.5%) agreed to participate in the study. The Poisson regression model known that university students with an income of R$ 1001 to 5000.00 and R$ 5001 or more primary, respectively, a prevalence ratio (PR) 14% (PR = 0,86; 95%CI 0,80-0,92) and 18% (PR = 0,82; 95%CI 0,74 a 0,90) lower of caries experience, as well as individualizing mothers had completed high school prevalence a 14% (PR = 0,86; 95%CI 0,80 a 0,92) lower prevalence and complete higher education 19% (PR = 0,81; 95%CI 0,75 a 0,87) less caries experi-ence when compared to reference groups. In the self-perception of oral health, the results for income of R$ 1001 to 5000.00 and R$ 5001 or more dissipated, respectively, a 23% (PR = 0,77; 95%CI 0,64 a 0,91) and 43% (PR = 0,57; 95%CI 0,45 a 0,72) lower prevalence of having negative self-perception of oral health and qualified originating from complete higher education reported a 23% lower prevalence of negative self-perceived oral health when compared to the reference (PR = 0,79; 95%CI 0,66 a 0,97). Conclusions: The findings of the present study confirm that socioeconomic indicators influence the experience of caries and self-perceived oral health among university students

Sedentary behavior, unhealthy food consumption and dental caries in 12-year-old schoolchildren: a population-based study

Abstract: This study analyzed the association between sedentary behavior (SB), unhealthy food consumption, and dental caries amongst 12-year-old schoolchildren. An epidemiological survey was carried out in the five largest cities (> 80,000 inhabitants) of the State of Mato Grosso do Sul, Brazil. Data were collected on decayed, missing and filled teeth index (DMFT), sociodemographic characteristics, SB, unhealthy food consumption, and water fluoridation status. The analysis was based on the theoretical framework established by J Sisson. Structural equation models were performed to test the association of dental caries experience with sociodemographic, contextual, and behavioral factors. The mean DMFT index in the five cities was 1.02 (95%CI: 0.39-1.66). Higher sedentary behavior (more than 2 hours/day) [standardized coefficient (SC) = 0.21 95%CI: 0.07-0.39] and higher unhealthy food consumption (more than 4 times/week) [SC = 0.23 (0.10-0.45)] were associated with higher DMFT index than their counterparts. Also, cities with fluoridated water were associated with lower DMFT index [SC = −0.85 (-1.20--0.50)]. Families who had a per capita income above the poverty line had a direct association with unhealthy food consumption [SC = −0.24 (-0.38--0.11)]. Unhealthy food consumption mediated the association of sedentary behavior on DMFT index [SC=0.07 (0.02-0.13)]. Sensitivity analysis confirmed the findings. Sedentary behavior mediated by unhealthy food consumption had a significant association with dental caries experience. Public policies must address transdisciplinary actions to reduce sedentary behavior and unhealthy food consumption and promote water fluoridation.

Risk factors for dental caries in Latin American and Caribbean countries

Abstract Identifying the risk factors for dental caries is vital in epidemiology and clinical practices for developing effective preventive strategies, both, at the individual and collective levels. Different causality/determination models have been proposed to understand the development process of dental caries. In the present review, we designed a model inspired by the world-known social determinants models proposed in the 90s and more recently in the 10s, wherein the contextual factors are placed more externally and encompass the individual factors. The contextual factors included those related to the cultural and societal values, as well as the social and health government policies. The individual factors were classified into the following categories: socioeconomic (social class, occupation, income, and education level), demographic characteristics (age, sex, and ethnicity), behavioral factors (non-use of fluoride dentifrice, sugar consumption, poor oral hygiene, and lack of preventive dental care), and biological factors (recent caries experience/active caries lesions, biofilm retentive factors, developmental defects of the enamel, disabilities, saliva amount and quality, cariogenic biofilm). Each of these variables was addressed, while focusing on the current evidence from studies conducted in Latin American and Caribbean countries (LACC). Based on the proposed model, educational aspects were addressed, and individual caries risk assessment and management decisions were proposed; further, implications for public health policies and clinical practice were described. The identification of modifiable risk factors for dental caries should be the basis for multi-strategy actions that consider the diversity of Latin American communities.

Association between fixed orthodontic treatment and dental caries: a 1-year longitudinal study

Abstract: This longitudinal study aimed to assess the association between the use of fixed orthodontic appliances and the incidence/increment of active caries lesions in adolescents and young adults over a one-year period. A total of 135 10-30-year-old individuals were divided into two groups: Group G0 was composed of individuals who required orthodontic treatment, but who did not undergo fixed orthodontic therapy over the study period (n=70); Group G1 was composed of individuals who used a fixed orthodontic appliance for 1 year (n=65). Data collection included a questionnaire and clinical oral examinations (plaque index, gingival index, and dental caries index), performed at baseline and after 1 year. Caries examination was performed by a single calibrated examiner, after tooth cleaning and drying, and included the recording of non-cavitated and cavitated, inactive and active lesions of all tooth surfaces. Poisson regression models were used to assess the association between the group and the following study outcomes: incidence (binary variable) and increment (counting variable). The incidence of active caries lesions was 4.8% in G0 and 39.6% in G1. The mean increment of active caries lesions was 0.14 in G0 and 0.61 in G1. G1 showed a greater risk of developing active caries lesions than G0 (incidence analysis, adjusted IRR=9.48, 95%CI=2.62-34.30; increment analysis, adjusted IRR=4.13; 95%CI=1.94-8.79). In conclusion, this study showed that individuals undergoing fixed orthodontic therapy for 1 year had a significantly higher incidence and increment of active caries lesions than those without a fixed appliance.

Dental caries and associated factors in Ethiopia: systematic review and meta-analysis

BACKGROUND@#Globally, dental caries may be a major public health issue which may be preventable. Many studies have been conducted on dental caries in Ethiopia which present inconsistent results.@*OBJECTIVE@#This meta-analysis was expected to consolidate the findings conducted in various regions of the country and generate country representative information on the burden and its associated factors of dental caries in Ethiopia.@*METHODS@#Our systematic review and meta-analysis was carried out to estimate the pooled prevalence of dental caries and its associated factors in the Federal Democratic Republic of Ethiopia. Medical specialty databases like ScienceDirect, HINARI, Embase, PubMed, Google Scholar, and Cochrane Library were consistently and exhaustively searched. To determine the aggregate prevalence, studies delineating the prevalence of dental caries and associated factors were included. Important data were extracted employing a standardized data extraction tool ready in Microsoft Excel and imported to the STATA version-13 statistical software package for analyses. To assess non-uniformity, the Cochrane Q test statistics and I@*RESULTS@#The result of thirteen studies disclosed that the overall prevalence of dental caries in the Federal Democratic Republic of Ethiopia was found to be 40.98 (31.62, 50.34). Within the subgroup analysis, the uppermost prevalence was determined in Tigray region (46.59% (24.64, 68.54)) whereas the bottom prevalence was determined in Addis Ababa (34.20% (8.42, 59.97)). Dental caries prevalence was considerably high among study subjects who consumed sweet food (OR= 2.4 (95% CI (1.91, 3.01))). But the presence of dental plaque (OR = 5.14 (95% CI (0.67, 39.39))) and habit of tooth- cleaning (OR = 0.71 (95% CI (0.17, 2.96))) were not statistically significant with the outcome of interest.@*CONCLUSION@#Our meta-analysis found that the prevalence of dental caries was comparatively high, and sweet food consumption was the most risk issue for dental caries in Ethiopia. The Ethiopian Federal Ministry of Health ought to offer a lot of attention to strengthen the oral health care system and also the implementation of community-level interference programs.

Prevalence of oral manifestations of hypophosphatemic rickets in patients treated in a peruvian pediatric hospital / Prevalencia de manifestaciones bucales del raquitismo hipofosfatémico de pacientes atendidos en un hospital pediátrico peruano

Objective: To describe the prevalence of oral manifestations of hypophosphatemic rickets in patients treated in a Peruvian referral pediatric hospital during the years 2012-2016. Material and methods: An observational, descriptive, retrospective, cross-sectional study was carried out. The sample consisted of patients diagnosed with hypophosphatemic rickets who attended the outpatient clinic of the Stomatology Service and the Genetics Service of the National Institute of Child Health (INSN), Lima, Peru, between the years 2012-2016. The research project was assessed and approved by the Research Ethics Committee of the Health Service. Medical records stored in a database of the health institution with the Code CIE E83.3, which corresponds to the diagnosis of Hypophosphatemic Rickets, were requested for the study. Results: Fifteen children received health care, of which only 10 were treated at the Stomatology Service. The distribution of the data was obtained from these 10 patients according to the proposed objective. A higher frequency of gingival lesions was found at the soft tissue level (41.18%); at the bone tissue level, only one case of dentigerous cyst was observed; and at the dental level, 90% of the patients had dental caries. Conclusion: The most frequent oral manifestations of hypophosphatemic rickets in pediatric patients treated at the National Institute of Child Health (2012-2016) were gingivitis and dental caries.

Objetivo:Describir la prevalencia de las manifestaciones bucales del raquitismo hipofosfatémico de pacientes atendidos en un hospital pediátrico de referencia peruano durante los años 2012-2016. Material y Métodos:Se realizó un estudio tipo observacional, descriptivo, retrospectivo, transversal. Para la selección de la muestra se consideró a los pacientes que acudieron a la consulta externa del Servicio de Odontoestomatología y el Servicio de Genética del Instituto Nacional de Salud del Niño, Lima, Perú; en el periodo comprendido entre los años 2012-2016 y que presentaron como diagnóstico Raquitismo Hipofosfatémico. El proyecto de investigación fue evaluado por un Comité de Ética en Investigación del servicio de salud. Se solicitaron las historias clínicas consignadas en una base de datos de la institución de salud con el Código CIE E83.3, que corresponde a este diagnóstico. Resultados: Fueron atendidos 15 niños, de los cuales solo 10 fueron tratados en el Servicio Odontoestomatología; siendo de estos 10 pacientes la distribución de los datos obtenidos según el objetivo propuesto. Se encontró mayor frecuencia de lesiones a nivel de tejido blando de gingivitis con 41.18%, a nivel de tejido óseo solo se presentó un caso de quiste dentígero; y a nivel de tejido dental el 90% de los pacientes presentó caries dental. Conclusión: Las manifestaciones bucales más frecuentes del raquitismo hipofosfatémico de pacientes pediátricos atendidos en el Instituto Nacional de Salud del Niño (2012-2016), fueron la gingivitis y caries dental.

Saúde bucal de pré-escolares: do processo carioso aos fatores determinantes e moduladores / Preschool oral health: from carious process to determining and modulators

Objetivo: objetivou-se avaliar a experiência de cárie e seus fatores determinantes e moduladores em pré- -escolares de um centro de educação infantil localizado no estado do Ceará. Método: trata-se de um estudo exploratório, descritivo e de abordagem quantitativa realizado com crianças do infantil IV e V do Centro de Educação Infantil Francisca Arruda de Pontes (Redenção, CE) e suas mães. Após consentimento, as mães responderam um questionário contendo perguntas desde os aspectos socioeconômicos e acompanhamento pelo serviço de saúde a conhecimento das doenças bucais. Posteriormente, as crianças foram submetidas à avaliação odontológica para registro do índice CEO-D, o qual corresponde à soma do número de dentes decíduos cariados (c), com extração indicada (e) e restaurados (o). Os dados foram tabulados e descritos como frequência relativa e absoluta. Resultados: das mães, 80,75% tinham renda de até 1 salário mínimo, 61,53% utilizavam creme dental na higiene oral de seu filho e 48,07% desconheciam as doenças bucais. Das crianças, 65,38% não eram atendidas pelo cirurgião-dentista e 50,00% consumiam diariamente bolacha doce. Das crianças avaliadas, 52,50% tinham dentes cariados, 70,00% não apresentavam dentes com extração indicada e nenhuma tinha dentes obturados/restaurados. A média do índice CEO-D foi 1,325. Conclusão: conclui-se que as crianças, apesar de terem baixa prevalência de cárie, apresentam, como fatores de risco determinantes, uma dieta cariogênica e, como fatores de risco moduladores, um reduzido conhecimento sobre doenças bucais, higiene oral inadequada, renda familiar insuficiente, baixa escolaridade e limitada procura por serviço de saúde, especialmente o odontológico.(AU)

Objective: to evaluate the experience of caries and its determining and modulating factors in preschoolers at an early childhood education center located in the state of Ceará. Method: this is an exploratory, descriptive study with a quantitative approach carried out with children from infant IV and V of the Francisca Arruda de Pontes Early Childhood Center (Redenção, CE) and their mothers. After consent, the mothers answered a questionnaire containing questions from the socioeconomic aspects and monitoring by the health service to knowledge of oral diseases. Subsequently, the children underwent dental evaluation to record the dmf Index, which corresponds to the sum of the number of decayed primary teeth (d), missing (m) and filled (f). The data were tabulated and described as relative and absolute frequency. Results: of the mothers, 80.75% had an income of up to 1 minimum wage, 61.53% used toothpaste in their child's oral hygiene and 48.07% were unaware of oral diseases. Of the children, 65.38% were not attended by the dentist and 50.00% consumed sweet cookies daily. Of the children evaluated, 52.50% had decayed teeth, 70.00% did not have teeth with indicated extraction and none had filled/ restored teeth. The average of the dmf Index was 1.325. Conclusion: it is concluded that children, despite having a low prevalence of caries, present, as determining risk factors, a cariogenic diet and, as modulating risk factors, a reduced knowledge about oral diseases, inadequate oral hygiene, family income insufficient, low education and limited demand for health services, especially dental care.(AU)

Vigilância em saúde bucal na perspectiva do georreferenciamento: análise da distribuição de cárie dentária em escolares de uma Unidade de Saúde / Oral health surveillance from the perspective of geo-referencing: analysis of dental caries distribution in schoolchildren of a primary health unit

Objetivo: O estudo buscou realizar um mapeamento ge-orreferenciado dos usuários escolares de uma Unidade de Saúde de Porto Alegre em relação à cárie dentária. Materiais e métodos: A pesquisa foi desenvolvida em uma Unidade de Saúde do Grupo Hospitalar Conceição. A população do estudo foi composta por 103 alunos, entre 6 e 17 anos, de 2 escolas de ensino fundamental. Os dados sobre a ne-cessidade de tratamento restaurador, vinculados à cárie dentária, foram obtidos dos prontuários dos pacientes cadastrados no Coinma, examinados pela equipe de saúde através do PSE, nos anos de 2016 e 2017, totalizando 103 prontuários. Para o georreferenciamento, foi utilizada a ferramenta online Google Maps®, onde foram adicionados marcadores na cor vermelha para alunos com necessidade de tratamento e verde para alunos sem necessidade de tratamento. Resultados: Da população do estudo, 30% apresentava alguma necessidade de tratamento. Os meni-nos apresentavam mais necessidades quando comparados às meninas, com ênfase na faixa etária entre 8­9 anos. Quanto à análise geovisual, foi possível identificar um aumento na concentração dos casos de estudantes com necessidades de intervenção em saúde bucal na área ROSA, onde moravam 53 (51,4%) dos alunos, sendo que 19 (35,84%) deles apresentavam necessidades, seguidos pelas áreas AZUL, onde 25 (24,3%) dos alunos avaliados, 5 (20%) apresentavam necessidades; AMARELA, com 14 (13,6%) alunos avaliados, 2 (14%) apresentavam neces-sidades; VERDE, com 11 (10,7) alunos avaliados, 5 (45,5%) apresentavam necessidade de tratamento. Conclusão: O georreferenciamento é um instrumento importante para a análise da distribuição espacial da cárie dentária. O presente estudo pode contribuir para a elaboração de políticas de saúde voltadas para a vigilância em saúde de abrangência local.

Objective: The study aimed to perform a georeferenced mapping of school users of a health unit in Porto Alegre in relation to dental caries. Materials and methods: This study was carried out in a he-alth unit of the Hospitalar Conceição Group. The school consisted of 103 students, aged 6 to 17, from 2 elementary schools. Data on the accessibility of restorative treatment linked to the disease were included in the medical records of patients registered with Coinma and compared by the health team through the PES in 2016 and 2017, totaling 103 records. For the georeferencing, the Google Maps® online tool was used, where red markers were added for students who needed treatment and green for students with no need of treatment. Results: Of the study population, 30% had some need of treatment. The boys had more needs when compared to the girls, with emphasis on the group aged between 8-9 years. Concerning to the geo-visual analysis, it was possible to identify an increase in the concentration of students with oral health intervention needs in the PINK area, where 53 (51.4%) students lived, and 19 (35.84%) needed treatment. Besides, in the BLUE areas, out of 25 (24.3%) of students, 5 (20%) showed needs; In the YELLOW area, out of 14 (13.6%) students evaluated, 2 (14%) showed treatment needs; In the GREEN area, out of 11 (10.7) students evaluated, 5 (45.5%) presented a need for treatment. Conclusion: Georeferencing is an important tool for the analysis of the spatial distribution of dental caries. The present study may contribute to the elaboration of health policies focused on local health surveillance.

Estudio de los Valores de Hemograma en Niños con Caries Temprana de la Infancia Severa / Study of Hemogram Values in Children with Severe Early Childhood Caries

RESUMEN: La caries temprana de la infancia severa (CTI-S) es una enfermedad crónica que afecta a niños menores de 6 años, produce dolor, infección y destrucción de los tejidos dentales. El dolor que experimentan los niños con CTI-S puede llevar a hábitos alimenticios alterados que pueden causar deficiencias nutricionales. El objetivo fue evaluar los valores de hemograma en niños con CTI-S y compararlos con los valores normales de referencia para la edad. Se realizó un estudio retrospectivo observacional. Se analizaron las fichas y hemogramas de 47 niños con CTI-S, clasificados como ASA 1, atendidos bajo anestesia general en el Hospital de la Fuerza Aérea de Chile. Se tomaron en cuenta los valores del hemograma en relación a: Hematocrito, Hemoglobina y VCM. Se realizaron test descriptivos para las variables en estudio y se utilizó el testt para comparar los valores de hemograma con los valores normales de referencia. Se encontró una disminución de los valores de hematocrito en 4 pacientes (8,5 %) y una disminución del valor de VCM en 17 pacientes (36,7 %). Se encontraron diferencias significativas al comparar los promedios obtenidos en relación a hematocrito, VCM y hemoglobina en niños con CTI-S con el promedio de referencia (p <0,001). De acuerdo con los resultados obtenidos en este estudio, podemos concluir que los niños con caries temprana de la infancia severa, tienen alteraciones en los valores promedio de hemograma en relación a hematocrito, hemoglobina y VCM.

ABSTRACT: Severe early childhood caries (S-ECC) is a multifactorial chronic disease that affects children under 6 years of age, produces pain, infection and destruction of the dental tissues. The pain experienced by children with SECC may lead to altered eating habits that may cause nutritional deficiencies. The aim of this study was to evaluate the hemogram values in children with severe early childhood caries, and compare them with age population reference values. An observational retrospective study was carried out. We analyzed the medical records and their respective hemograms of 47 children with S-ECC, classified as ASA1, attended at the Chilean Air Force Hospital under general anesthesia. The hemogram values were taken into account in relation to: hematocrit, hemoglobin and mean corpuscular volume (MCV). Descriptive tests were carried out for the variables under study and the t-test was used to compare the hemogram values with the normal reference values. A decrease in hematocrit values was found in 4 patients (8.5 %) and a decrease in the value of MCV in 17 patients (36.7 %). Significant differences were found when comparing the averages obtained in relation to hematocrit, hemoglobin and MCV in children with S-ECC with the reference average (p <0.001). According to the results obtained, in this study, we can conclude that children with severe early childhood caries, have alterations in the average of hemogram values in relation to hematocrit, hemoglobin and MCV.

Nivel de conocimientos y prácticas sobre salud bucodental de estudiantes de posgrado de la Carrera de Enfermería de la Facultad de Ciencias de la Salud de la Universidad Católica de Asunción / Level of knowledge and practices on oral health of graduate students of the Nursing Career of the Faculty of Health Sciences of the Catholic University of Asunción

Los adultos jóvenes constituyen gran parte de la población paraguaya y se considera que los conocimientos y prácticas sobre salud bucodental están muy relacionados al nivel de instrucción, el objetivo de este estudio fue evaluar el nivel de conocimientos y prácticas sobre salud bucodental de estudiantes de posgrado de la Carrera de Enfermería de la Facultad de Ciencias de la Salud de la Universidad Católica de Asunción (CE FCSUCA), en el 2018. Estudio observacional descriptivo de corte transversal con componente analítico en el que se incluyeron a todos los estudiantes de posgrado entre mayo y junio de 2018. La recolección de datos se realizó mediante un cuestionario sobre salud bucodental autoadministrado y de carácter anónimo. Los datos se asentaron en una planilla electrónica, y fueron analizados utilizando el Programa estadístico IBMSSPS 23.0. La muestra estuvo constituida por 166 estudiantes, en su mayoría del sexo femenino (75,3%), de entre 20 y 29 años (54,8%), cursando algún programa de especialización (57,8% y pertenecientes al área de la salud (94%). El 57,83% y el 55,42% de los estudiantes presentaron conocimientos y prácticas de salud bucodental de nivel regular, respectivamente. Se encontró asociación entre nivel de conocimiento y de práctica y entre el nivel de conocimiento y la edad. Se concluye que los niveles de conocimientos y prácticas sobre salud bucodental en los estudiantes de posgrado fueron deficientes por lo que se propone la implementación de estrategias educativas de concienciación en el área(AU)

Young adults constitute a large part of the Paraguayan population and considering that oral health knowledge and practices are closely related to the level of education, the objective of this study was to evaluate the level of knowledge and practices on oral health of postgraduate students of the Nursing Career of the Faculty of Health Sciences of the Catholic University of Asunción (CE FCSUCA), in 2018. The design was descriptive, cross-sectional with an analytical component in which all postgraduate students were included in May and June 2018. Data collection was carried out through a questionnaire on oral health self-administered and anonymous. The data were recorded in an electronic spreadsheet and analyzed using the IBMSSPS 23.0 Statistical Program. The sample consisted of 166 students, mostly female (75.3%), between 20 and 29 years old (54.8%), studying some specialization program (57.8%) and belonging to the area of Health (94%). 57.83% and 55.42% of the students presented knowledge and practices of oral health at the regular level, respectively. An association was found between the level of knowledge and practice and between the level of knowledge. It is concluded that the levels of knowledge and practices on oral health in the postgraduate students were insufficient, so the implementation of educational awareness strategies in the area is proposed(AU)

Serão as bactérias cariogénicas o fator de risco maior para cáries dentárias em doentes com retocolite ulcerativa? / Are cariogenic bacteria the major risk factor to dental caries in patients with ulcerative colitis?

ABSTRACT BACKGROUND: High prevalence of dental caries in ulcerative colitis (UC) has been attributed to diet and changes in salivary environment. OBJECTIVE: We aimed to characterize the prevalence of dental caries, salivary flow rates, salivary buffering capacity and cariogenic bacteria counts of Mutans streptococci and Lactobacillus spp and to evaluate their relationship with drug therapy, disease activity and duration. METHODS: A cross-sectional study was performed with UC patients followed in a tertiary center. Participants were submitted to a questionnaire (including demographic data, oral hygiene, eating habits) and a clinical observation with assessment of plaque index and Decayed, Missing and Filled Teeth index. Unstimulated/stimulated saliva was collected. Medical records, disease activity (Partial Mayo Score) and disease duration were collected. Laboratory data included salivary flow rates, salivary buffering capacity (CRT® buffer) and cariogenic bacteria count (Mutans streptococci and Lactobacillus spp) in saliva using the CRT® bacteria test (results: high or low counts). RESULTS: Thirty UC patients were recruited. Oral hygiene routines were daily teeth brushing once or more (96.7%) and fluoride toothpaste (73.3%). Decayed, Missing and Filled Teeth index (mean 16.17±6.428) was not affected by the frequency of soft drinks, cakes, sweets and sugars between meals (P>0.2). Long-term disease showed a trend towards higher prevalence of caries (P=0.06). Most presented normal salivary flow rates, unstimulated (73.3%) and stimulated (60.0%), and high salivary buffering capacity (66.7%). Any association was found with age, gender, disease activity, disease duration and drug therapy. High Mutans streptococci and low Lactobacillus spp count were observed in 73.3% and 60% of patients, respectively. Patients with active disease (100%) and longer duration (88.9%) displayed higher Mutans streptococci count. CONCLUSION: The prevalence of dental caries observed in UC patients was significant and did not seem to be influenced by their eating habits. The high prevalence of Mutans streptococci count may be a major risk factor for dental caries and may be looked as part of the UC dysbiosis. Dental care of UC patients should be planned according with this microbiota variation.

RESUMO CONTEXTO: Uma elevada prevalência de cáries dentárias em doentes com retocolite ulcerativa (RCU) tem sido atribuída à dieta e alterações no ambiente salivar. OBJETIVO: Este estudo pretende caracterizar a prevalência de cáries dentárias, taxas de fluxo salivar, capacidade de tamponamento da saliva e contagem de bactérias cariogénicas, Streptococcus mutans e Lactobacillus spp e avaliar a sua relação com a terapêutica farmacológica e a atividade e duração da doença. MÉTODOS: Estudo transversal com doentes com RCU seguidos num centro terciário. Os participantes foram submetidos a um questionário (incluindo questões sobre dados sociodemográficos, higiene oral e hábitos alimentares), e a uma observação clínica com avaliação do índice de placa e índice Decayed, Missing and Filled Teeth. Amostras de saliva não estimulada e estimulada foram colhidas. Os registos clínicos, a atividade da doença (score parcial de Mayo) e a sua duração foram avaliados. Os dados laboratoriais incluíram taxas de fluxo salivar, capacidade de tamponamento da saliva (CRT® buffer) e a contagem de bactérias cariogénicas (Streptococcus mutans e Lactobacillus spp) utilizando o teste CRT® (resultado: contagem elevada ou reduzida). RESULTADOS: Foram recrutados 30 doentes com RCU. As rotinas de higiene oral incluíram a escovagem dos dentes uma ou mais vezes por dia (96,7%) e o uso de pasta com flúor (73,3%). O índice Decayed, Missing and Filled Teeth (média 16,17±6,428) não foi afetado pela frequência de ingestão de refrigerantes, bolos, doces e açucares entre as refeições (P>0,2). Doentes com doença de longa duração apresentaram uma tendência para maior prevalência de cáries dentárias (P=0,06). A maioria possuía taxas de fluxo salivar normais, quer de saliva estimulada (60%) quer de saliva não estimulada (73,3%), assim como taxas de tamponamento salivar elevadas (66,7%). Não foi encontrada associação entre estas características com a idade, género, atividade/duração da doença e tipo de terapêutica farmacológica. Contagens elevadas de Streptococcus mutans e reduzidas de Lactobacillus spp foram observadas em 73,3% e 60% dos doentes, respectivamente. Doentes com doença ativa e maior tempo de evolução apresentaram contagens superiores de Streptococcus mutans. CONCLUSÃO: A prevalência de cárie dentária observada em doentes com RCU foi significativa e não parece ser influenciada pelos hábitos alimentares. A prevalência aumentada de Streptococcus mutans foi o fator de risco maior para a cárie dentária e provavelmente constitui parte da conhecida disbiose oral associada à RCU. Os cuidados dentários a estes doentes deverão ter em consideração esta variação da microbiota.

Fatores associados à experiência de cárie e qualidade de vida relacionada à saúde bucal em escolares / Factors associated with caries experience and oral health-related quality of life in schoolchildren

Objetivo: avaliar a associação do nível socioeconômico da família e o grau de conhecimento dos pais sobre saúde bucal e a experiência de cárie e qualidade de vida relacionada à saúde bucal de escolares de 12 anos no município de Estação, RS. Métodos: a partir de um levantamento epidemiológico, 50 crianças (taxa de resposta: 81%) foram avaliadas por meio de exame clínico bucal, utilizando como critério de diagnóstico o índice de dentes permanentes cariados, perdidos e obturados (CPO-D), e entrevista estruturada, utilizando a versão brasileira reduzida do Child Perceptions Questionnaire 11-14 (CPQ 11-14), para medir o impacto das condições de saúde bucal na qualidade de vida. Os responsáveis responderam um questionário sobre condição socioeconômica da família, procura por atendimento odontológico e conhecimentos sobre saúde bucal. Foram considerados três desfechos distintos: experiência de cárie, presença de cárie não tratada e a severidade do CPQ 11-14. Resultados: a prevalência de cárie foi de 46%; desses, 24% possuíam pelo menos um dente com cavidade de cárie não tratada. A experiência de cárie e presença de lesões não tratadas foram associadas a fatores psicológicos, como a autopercepção em saúde bucal, e fatores socioeconômicos (possuir plano de saúde e tipo de serviço odontológico utilizado). Além disso, a autopercepção também se mostrou associada a fatores socioeconômicos e ao conhecimento dos pais sobre saúde bucal. Conclusão: fatores psicossociais, nível econômico da família e conhecimentos dos pais sobre saúde bucal estão associados à ocorrência de cárie e ao maior impacto na qualidade de vida em escolares.(AU)

Objective: this study assessed the association of the socioeconomic status of families and the knowledge of parents regarding oral health in caries experience, as well as the oral health-related quality of life of 12-year-old schoolchildren in the city of Estação, RS, Brazil. Methods: an epidemiological survey included the assessment of 50 children (response rate: 81%) through clinical oral examinations using the index of permanent decayed, missed and filled teeth (DMF-T) as diagnostic criterion. Structured interviews were also conducted using the Brazilian short version of the Child Perceptions Questionnaire 11-14 (CPQ11-14) to measure the impact of oral health conditions on quality of life. The parents answered a questionnaire about the socioeconomic status of the family, search for dental care, and oral health knowledge. Three different outcomes were considered: caries experience, presence of untreated caries, and severity of CPQ11-14. Results: The prevalence of caries was 46% from which 24% presented at least one tooth with an untreated cavity. Caries experience and the presence of untreated caries were associated with psychological factors (oral health self-perception) and socioeconomic factors (having health insurance and type of dental service used). In addition, oral health self-perception was associated with socioeconomic factors and the knowledge of parents on oral health. Conclusion: psychosocial factors, economic status of the family, and the knowledge of parents on oral health are associated with the occurrence of caries and the higher impact on the quality of life in schoolchildren.(AU)

In Vitro Comparison of ICDAS And DIAGNOdent Pen in The Diagnosis and Treatment Decisions of Non-Cavitated Occlusal Caries / Comparación In Vitro de ICDAS y DIAGNOdent Pen en el diagnóstico y decisiones de tratamiento de la caries oclusal no cavitada

Abstract The aim of this study was to compare the efficacy of the ICDAS and the DIAGNOdent Pen in the diagnosis of occlusal caries lesions without cavitation, and for basing treatment decisions on the results obtained. Eighty permanent molar teeth that were healthy and non-cavitated or that had an initial occlusal lesion were evaluated. All teeth were investigated using DIAGNOdent Pen and ICDAS by four examiners. Histological evaluation of teeth was performed using stereomicroscopy by a histologist and different experienced dentist. For evaluation of the data, weighted kappa values (kw), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratio (LR+) values of the tests were calculated. The diagnostic results obtained using the DIAGNOdent Pen were found to correlate better with the results obtained from histological sections than those obtained using ICDAS. When the treatment decisions of the observers depending on the results of ICDAS, and ICDAS and DIAGNOdent Pen combination were compared with the decisions made based on histological examinations, the decisions based on ICDAS and DIAGNOdent Pen combined (kw: 0.522) were more accurate than the ones based on ICDAS (kw: 0.415) alone. In conclution, professional experience is an effective factor in diagnosing occlusal caries lesions without cavitation with ICDAS and in making treatment decisions for them. DIAGNOdent Pen is sufficient in diagnosing occlusal caries lesions without cavitation.

Resumen El objetivo de este estudio fue comparar la eficacia de ICDAS y de DIAGNOdent Pen en el diagnóstico de lesiones de caries oclusales no cavitadas. Ochenta molares permanentes sanos y no cavitados fueron utilizados. Todos los dientes fueron investigados usando DIAGNOdent Pen e ICDAS por cuatro examinadores. La evaluación histológica de los dientes se realizó mediante estereomicroscopía por un histólogo y por un dentista con previa experiencia. Los resultados diagnósticos obtenidos con el DIAGNOdent Pen se correlacionan mejor con los resultados obtenidos a partir de las secciones histológicas cuando comparados a los obtenidos utilizando ICDAS. Las decisiones basadas en el uso combinado de ICDAS y DIAGNOdent Pen (kw: 0.522) fueron más precisas que los basados en ICDAS (kw: 0.415). En conclusión, la experiencia profesional es un factor eficaz en diagnóstico de lesiones de caries oclusal sin cavitación con ICDAS y en la toma de decisiones de tratamiento. DIAGNOdent Pen es una herramienta confiable para diagnosticar lesiones de caries oclusales sin cavitación.