Diagnosing non-cavitated lesions in epidemiological studies: practical and scientific considerations

Over the last decade, there has been growing interest in diagnosing non-cavitated lesions in epidemiological studies involving large numbers of preschool children, schoolchildren and young adults. In this context, assessment of lesions characteristics indicating whether or not there is ongoing mineral loss is also considered relevant. The reasoning sustained by these studies is that diagnosis of the caries process limited to the cavitated level is no longer in accordance with current state-of-the-art knowledge in cariology. This paper highlights one topic of the lecture entitled "Caries Process: Evolving Evidence and Understanding," presented at the 18th Congress of the Brazilian Association for Oral Health Promotion (Associação Brasileira de Odontologia de Promoção de Saúde - ABOPREV) in April 2013. In the framework of epidemiological studies, the interest in diagnosing active and inactive non-cavitated lesions was elucidated. However, relevant questions associated with the diagnosis of non-cavitated lesions that might raise concerns among researchers and health administrators were not addressed. The present paper aims to bring these questions into discussion. The contribution of this discussion in terms of developing the understanding of caries decline is analyzed by using data from a caries trends study of Brazilian preschool children residing in the Federal District of Brazil as an example. The inclusion of active and inactive non-cavitated lesions in the diagnosis of the caries process allowed us to demonstrate that, in Brazilian 1- to 5-year-old children, caries prevalence decreased significantly from 1996 to 2006, simultaneously with a reduction in the rate of caries progression.

Case Report Form for oral health assessments: methodological considerations

Information on the oral health condition of the target population is required to enable the development of policy strategies for oral health promotion. This information needs to be substantiated by reliable data obtained through regular oral health assessments. Countries around the world have set up oral health data-registration systems that monitor the oral health of the population. These systems are either integrated in the public oral health care service or in national surveys conducted on a regular basis. This paper describes the conception and development of a Case Report Form for oral health assessments and introduces a recently developed electronic data-registration system for data capture in oral health surveys. The conception and development of a Case Report Form poses a number of challenges to be overcome. In addition to ensuring the scientific quality of its contents, several requirements need to be met. In the framework of national oral health surveys, handwritten data capture has proven accurate, but entails an important workload related to the printing and transporting of the forms, data transfer and storage of the forms, as well as the time required to perform these tasks. On the other hand, electronic data capture enables time saving and better performance. However, the advantages of this system may not be fully acknowledged by general practitioners, and their motivation to employ information and communication technologies may need to be encouraged. In the long term, the inclusion of electronic data registration in university training is probably the best strategy to achieve this.

Desempenho clínico das escovas infantis produzidas no Brasil / Clinical performance of young toothbrushes produced in Brazil

O objetivo do estudo foi avaliar o desempenho clínico de 16 escovas de dentes infantis nacionais com relação à habilidade de remover placa na dentição decídua. Os preços médios das escovas variaram de US$ 0,50 a 3,50. Oito crianças de 4-6 anos de idade foram examinadas 4 vezes durante o estudo. As crianças não tiveram seus dentes escovados nas 48 horas que precediam cada exame e a placa corada foi registrada nas superfícies lisa e oclusal. A escovação profissional foi realizada pelo método de Bass modificado sem o uso de dentifrício. Os resultados do estudo revelaram que independente da marca e preço as escovas foram eficientes em remover placa na dentição decídua. As escovas testadas não apresentaram diferenças significantes no que diz respeito à habilidade em remover placa

Influência da concentraçäo salina da raçäo na incidência de cárie em ratos / The influence of the salt concentration of the diet on the incidence of caries in rats

Neste trabalho, os autores apresentam dados experimentais procurando demonstrar a interrelaçäo entre a potencialidade osmótica da dieta e sua cariogenicidade. Para tanto, foram usados ratos machos desmamados e submetidos a dois diferentes tratamentos. No primeiro, os animais receberam raçäo pulverizada de laboratório, contendo ou näo uma mistura de sais (seis por cento), durante o período de 30 dias e posteriormente submetidos a uma dieta cariogênica rica em açúcar) por 45 dias. No segundo, os ratos receberam dieta cariogênica contendo ou näo sais, por um período de 75 dias. Após o período experimental, os animais foram sacrificados e suas mandíbulas e maxilas removidas para a avaliaçäo dos escores de cáries. Os resultados demonstram que, tanto no grupo que recebeu, previamente, os sais na raçäo de laboratório, quanto nos que os receberam na dieta cariogênica, apresentaram maiores escores de cáries do que os seus controles. Baseados nestes resultados, os autores concluem que o aumento dos escores de cáries produzido pelas dietas salinas é devido, pelo menos em parte, á açäo local dos sais sobre o dente