Fluoride in Bottled Waters Consumed in Northeastern Brazil

ABSTRACT Objective: To assess the fluoride concentration of bottled waters from municipalities in northeastern Brazil. Material and Methods: Bottled mineral waters were purchased in two periods at different commercial places of four large municipalities (João Pessoa, Campina Grande, Patos, and Cajazeiras) in the Paraíba state. The municipalities selected to present the following annual average temperature: João Pessoa 26.5 °C, Campina Grande 23.3 °C, Patos and Cajazeiras 27.5 °C. Fluoride concentration was determined using a combined ion-specific electrode. Readings (in mV) were conducted in triplicates for each standard solution and converted into fluoride concentration (mg F/L) using the Excel® software. Results: A total of 72 samples from six brands of bottled water were analyzed. The fluoride concentrations of all samples were low (0.11-0.21mg/L) but higher than those reported on the label and varied among different batches of the same brand. Conclusion: The fluoride levels in bottled water vary among brands, and these actual values are not stated in the labels.

Actividad antifúngica y la caracterización física de un dentífrico experimental que contiene carvacrol / Antifungal activity and physical characterization of an experimental dentifrice containing carvacrol

Introduction: The successful treatment of oral candidiasis depends on three essential principles, namely: early and accurate diagnosis, correlation with predisposing factors or underlying diseases that compromise immunity, and appropriate use of antifungal drugs. Objectives: To determine the minimum inhibitory concentration of carvacrol against Candida albicans and to develop and evaluate the in vitro antifungal activity (diameter of inhibition zone) and physical properties (foaming capacity, spreadability and cleaning capacity) of an experimental dentifrice containing carvacrol. Methods: The carvacrol was incorporated into a dentifrice base at different concentrations and tested for its minimum inhibitory concentration and agar diffusion against Candida albicans and the physical properties. Data were analysed by ANOVA. Results: The minimum inhibitory concentration of carvacrol was 1041.67 ± 360.84 µg/mL. The dentifrice containing carvacrol C1 e C2 produced an inhibition zone of 27.50 ± 2.12 mm and 36.66 ± 2.08 mm, respectively (p<0.05). As for the physical properties, the dentifrices showed no foaming capacity, while their cleaning capacity and spreadability remained unaltered. Conclusions: The experimental dentifrices containing carvacrol showed antifungal activity. The incorporation of carvacrol significantly altered the foaming capacity of the formulations, without any significant effects on their cleaning capacity and spreadability(AU)

Introducción: El tratamiento exitoso de la candidiasis oral depende de tres principios esenciales, a saber: diagnóstico temprano y preciso, correlación con factores predisponentes o enfermedades subyacentes que comprometan la inmunidad y uso apropiado de medicamentos antimicóticos. Objetivos: Determinar la concentración inhibitoria mínima de carvacrol contra Candida albicans y desarrollar y evaluar la actividad antifúngica in vitro (diámetro de la zona de inhibición) y las propiedades físicas (capacidad espumante, esparcibilidad y capacidad de limpieza) de un dentífrico experimental que contiene carvacrol. Métodos: El carvacrol se incorporó a una base dentífrica a diferentes concentraciones y se probó su concentración mínima inhibitoria y difusión en agar contra Candida albicans y las propiedades físicas. Los datos fueron analizados por ANOVA. Resultados: La concentración mínima inhibitoria de carvacrol fue 1041,67 ± 360,84 µg/mL. El dentífrico con carvacrol C1 y C2 produjo un halo de inhibición de 27,50 ± 2,12 mm y 36,66 ± 2,08 mm, respectivamente (p < 0,05). En cuanto a las propiedades físicas, los dentífricos no mostraron capacidad espumante, mientras que su capacidad de limpieza y esparcibilidad permanecieron inalteradas. Conclusiones: Los dentífricos experimentales que contenían carvacrol mostraron actividad antifúngica. La incorporación de carvacrol alteró significativamente la capacidad espumante de las formulaciones, sin efectos significativos sobre su capacidad de limpieza y esparcibilidad(AU)

Level of natural fluoride in public water supply: geographical and meteorological factors in Brazil's Northeast

Abstract This study analyzed the relationships between the concentration of natural fluoride in public water supply and meteorological and hydrographic factors in a northeastern region of Brazil. This was a descriptive, analytical, ecological, longitudinal, and field study conducted by collecting water in 23 municipalities (2019 to 2020) of four macroregions of Paraíba (Brazil): coast (1), borborema (2), agreste (3), and outback (4). Four collection sites were selected per municipality: two near and two distant from the water treatment plant. Fluoride concentration was determined using a combined ion-specific electrode and classified according to the Collaborating Center of the Ministry of Health in Oral Health Surveillance. Meteorological, hydrographic, and population characteristics were also collected. All analyzed samples showed natural fluoride; macroregions 2 and 4 showed the highest mean fluoride concentration, macroregion 4 presented the highest mean temperature, and all macroregions showed a similar pattern of precipitation. The mean fluoride concentration of the four macroregions was below the appropriate value to prevent caries. An increase in precipitation would decrease the fluoride concentration in water. In conclusion, the concentration of natural fluoride varied according to meteorological and hydrographic factors. The concentration in surface waters increased during periods of low precipitation. Therefore, this study provided important information to support implementation of community water fluoridation in this region.

Consensus for teaching dental caries in the Portuguese Language at Brazilian dental schools

Abstract The aim of this paper was to present a summary of the process of developing and preparing the final documents of the national consensus for teaching undergraduate Brazilian dental students the dental caries curriculum in the Portuguese language. The final document was developed in three steps: a) The ABENO and LAOHA cariology group invited experts from all five regions of Brazil to participate in the discussion. The theoretical support for crafting the first draft of the consensus was based on two publications: National Curriculum Guidelines of the Dentistry graduation in Brazil, Ministry of Education (2021) and the competences described in the European Core Curriculum for Cariology (ORCA-ADEE, 2011); b) The group of experts was divided into 5 working groups: G1-Domain, Main and Specific Competences, G2-Essential knowledge, G3-Life course perspective, G4-Social determinants and dental caries, G5- Glossary. The document was finalized by thoroughly reviewing the process using Delphi methodology; c) The 5-chapter document (one from each working group) was submitted to three open public consultations in 2022 (May-June, August, and October) using Google-forms. The suggestions (content/wording) were discussed within the group as: totally accepted, partially accepted, and rejected. A total of 192 suggestions were registered from 31 dental schools in all regions of Brazil. The number of suggestions received per Group were: 84, 28, 26, 24, 30 suggestions for G1, G2, G3, G4 and G5, respectively. The majority of suggestions were totally accepted by the group of experts (n = 172, 89.6%), 15 were partially accepted (7.8%), and 5 were rejected. Conclusion The final document could be considered to be the first national consensus for teaching the dental caries curriculum in Brazil.

Core Cariology Curriculum Framework in Spanish for Latin American dental schools: development and consensus

Abstract The aim of this study was to develop and achieve consensus on a cariology teaching framework for dental schools in Latin American Spanish-speaking countries. The Delphi process, with a ≥8 0% pre-defined participants' agreement, included three phases and a Coordinating Group. During the Preparation phase three panels of experts were selected and invited to participate: a) Regional academic/professional Dental Associations (Associations-Panel): n = 12; b) Regional Dental Schools (Dental-Schools-Panel): existing dental schools (n = 263) from the 19 Spanish-speaking regional countries; c) International academic/professional associations Peer Experts (Peer-Panel): n = 4. Based on consensus documents from Europe, Colombia, the Caribbean, USA, Chile and Spain, and updated scientific evidence, the Coordinating Group developed a baseline framework proposal of domains, main competencies (MC) and specific competencies (SC). The Consultation-Agreement and Consensus phases included three rounds of questionnaires with a step-wise sharing of the MC updated version of the consensus framework with the Dental-Schools-Panel and including SC with the Associations-Panel. Diverse communication strategies were used ( e.g ., independent google-form questionnaires and workshops). Consensus was reached after an on-site Associations-Panel workshop and secret voting, followed by an online meeting with the Peers-Panel. A total of 127 academic/professional institutions participated (Associations-Panel: 11, 91.6%; Dental-Schools-Panel: 112, 42.6%, all countries; Peers-Panel: 4, 100%). The baseline Cariology teaching framework of 5 domains, 10 MC and 92 SC underwent modifications after agreements for a final consensus framework consisting of 5 domains, 10 MC and 85 SC. A Core Cariology curriculum framework in Spanish for Latin American Dental Schools was successfully developed and agreed upon with regional dental academic and professional institutions.

Impact of the first thousand days of life on dental caries through the life course: a transdisciplinary approach

Abstract This review aimed to describe the importance of the first 1000 days of a child's life as a golden period for interventions and actions to prevent dental caries and other chronic non-communicable diseases (NCDs) throughout the life course and highlight that the first 450 days of life could be even more important for oral health. During the first 1000 days of life (pregnancy and first two years of life), health care providers can identify unhealthy lifestyles, behaviors, and their determinants. Bearing in mind contextual factors like socioeconomic conditions and cultural aspects, this is a unique period to work together with the family and identify opportunities for adopting healthy habits that might last throughout the life of the expected or newborn child. This is a "window of opportunity" for the prevention of chronic NCDs of both systemic and oral origin, such as overweight, obesity, diabetes, cardiovascular diseases, and dental caries. In fact, to effectively prevent dental caries, pregnancy and the first 6 months of a child's life (first 450 days) should be considered the critical period to work together with families to facilitate the adoption of healthy habits. Knowledge about the first thousand days of life is essential and represents a crucial period for the implementation of actions and interventions that will guarantee good oral and general health development that can persist throughout life.

Effect of dentifrices with different pH and fluoride concentrations on fluoride levels in biofilm and nails: an RCT

Abstract: Purpose: to evaluate the effect of dentifrice pH and fluoride concentration ([F]) on fluoride uptake on the biofilm and nails of children from a non-fluoridated area. Methods: two hundred and twenty-eight two- to four-year-old children were randomly allocated into 3 groups according to the type of dentifrice: G1: 1100 μg F/g, pH 4.5 (n = 76); G2: 750 μg F/g, pH 4.5 (n = 74); and G3: 1100 μg F/g, pH 7.0 (n = 78). Nails were collected at 4, 8, and 12 months after starting dentifrice use and biofilm was collected 5 and 60 minutes after toothbrushing. The concentrations of F in nails and biofilm were analyzed by HMDS facilitated diffusion. Data were analyzed by Kruskal-Wallis/Mann-Whitney's test and the comparison between biofilm collection times was done using Wilcoxon test (p £ 0.05). Results: a significant reduction of [F] in biofilm was observed 60 minutes after toothbrushing, regardless of the dentifrice used. However, 5 minutes after toothbrushing, G1 had a significantly higher [F] compared to G2 and G3, and 60 minutes after toothbrushing, [F] was significantly higher for G1 and G2 compared to G3. G1 and G3 had significantly higher [F] in the nails compared to G2. Conclusion: a lower dentifrice concentration is a relevant factor for the reduction of excessive fluoride intake. The use of a low-F acidified dentifrice combines the reduction of fluoride uptake with caries prevention by leading to greater incorporation of F into the biofilm over time.

Effect of treatment time on performance of nano-encapsulated fluoride dentifrices for remineralization of initial carious lesions: an in vitro study / Efeito do tempo de tratamento no desempenho de dentifrícios de fluoreto nanoencapsulado para remineralização de lesões iniciais de cárie: um estudo in vitro

ABSTRACT The aim of this in vitro study was to evaluate the influence of treatment time on the remineralization performance of nanoencapsulated fluoride dentifrices on initial carious lesions. Ninety-six human enamel samples were allocated to eight groups (n = 12): 50% NanoF + 50% free NaF, 100% NanoF, 100% NaF (positive control), and placebo (negative control), using two different treatment times (one and five minutes) for each dentifrice tested. After the carious lesion induction, the specimens were submitted to a pH remineralizing cycling model for seven days. Surface microhardness was measured before and after carious lesion induction and after treatment. The percentage of surface remineralization was calculated for each study time. Data were analyzed using two-way ANOVA and ANOVA repeated-measures tests followed by the Bonferroni correction (p < 0.05). Remineralization differences were observed in the dentifrices analyzed according to the treatment time used. NanoF formulations with 50% (one-min treatment) and 100% (five-min treatment) promoted significant remineralization of enamel after the caries challenge when compared to the placebo dentifrice (p < 0.05). Thus, time was considered an important factor for the fluoride release system. Nanotechnology can be a promising system for caries remineralization as it makes fluoride available on the dental surface for a longer time.

RESUMO O objetivo deste estudo in vitro foi de avaliar a influencia do tempo de tratamento no desempenho de dentifrícios fluoretados nano-encapsulados na remineralizagao de lesoes cariosas iniciáis. Noventa e seis amostras de esmalte humano foram divididas em oito grupos (n = 12): 50% NanoF + 50% NaF livre, 100% NanoF, 100% NaF (controle positivo) e Placebo (controle negativo) com dois tempos diferentes (um e cinco minutos). Após a indugao da lesao cariosa, os espécimes foram submetidos a um modelo de ciclagem de pH por sete dias. A microdureza superficial foi medida antes e após a indugao da lesao cariosa e após o tratamento. O percentual de remineralizagao superficial foi calculado para cada tempo de estudo. Os dados foram analisados pelo ANOVA e ANOVA de medidas repetidas, seguida de Bonferroni (p <0,05). Diferengas de remineralizagao foram observadas nos dentifrícios de acordo com o tempo de tratamento utilizado. Formulagoes NanoF com 50% (tratamento de um minuto) e 100% (tratamento de cinco minutos) promoveram uma remineralizagao do esmalte, após o desafio cariogènico, quando comparado com o dentifricio placebo (p <0,05). Assim, o tempo foi considerado um fator importante para o sistema de liberagao de flúor. A nanotecnologia pode ser um sistema promissor de remineralizagao da cárie, por disponibilizar o flúor por maior tempo na superficie dentària.

Layered double hydroxides for controlled fluoride release

Abstract This study aims to develop a nano-sized fluoridated layered double hydroxide (LDH)-based release system via hydrothermal treatment for the controlled delivery of fluoride (F-) ions in the oral environment. The synthesis of conventional LDH-type (C-LDH) precursor nanomaterials was conducted using a co-precipitation method at constant pH, and the nanoparticulate-LDH (N-LDH) was synthesized by a hydrothermal procedure. Fluoride LDH (F-LDH) products were obtained through indirect synthesis using the precursor ion-exchange technique by varying the agitation time (2 and 24 h) and temperature (25 and 40 °C) to produce 12 material samples. The materials were characterized by energy dispersive x-ray, hexamethyldisilazane, digital radiography x-ray, Fourier-transform infrared, thermogravimetric analysis, and scanning electron microscopy. Additionally, the F-release kinetic profile was evaluated for 21 d in neutral and acid media with mathematical model analysis. Products with varying F-quantities were obtained, revealing specific release profiles. In general, there was a higher F-release in the acid medium, with emphasis on F-LDH-8. Fluoride-LDH and controlled fluoride delivery was successfully obtained, proving the potential of these nanomaterials as alternative anti-caries agents.

Dental caries prevalence, prospects, and challenges for Latin America and Caribbean countries: a summary and final recommendations from a Regional Consensus

Abstract Dental caries can be effectively managed and prevented from developing into cavitated lesions while preserving tooth structure at all levels. However, the strong correlation between caries and socioeconomic factors may compromise the efficacy of preventive strategies. The high prevalence of persistent inequalities in dental caries in Latin American and Caribbean countries (LACC) is a matter of concern. The estimates of the burden of disease in some countries in this region are outdated or absent. This paper aims to summarize and present the final recommendations of a regional Consensus for Dental Caries Prevalence, Prospects, and Challenges for LACC. This consensus is based on four articles that were written by a team of Latin American experts, reviewed by dental associations, and presented and discussed in two consensus events. The following domains were explored: epidemiology, risk factors, prevention strategies, and management of dental caries with a focus on restorative procedures. Dental caries can manifest throughout the lifespan of an individual, making it a matter of concern for infants, children, adults, and older people alike. The prevalence rates of untreated caries in deciduous and permanent teeth are high in many parts of the world, including LACCs. Previous evidence suggests that the prevalence of dental caries in 12-year-olds is moderate to high in most Latin American countries. Moreover, the prevalence of treatment needs and dental caries in the adult and elderly population can also be regarded as high in this region. The risk/protective factors (e.g., sugar consumption, exposure to fluoride, and oral hygiene) probably operate similarly in all LACCs, although variations in the interplay of these factors in some countries and within the same country cannot be ruled out. Although salt and water fluoridation programs are implemented in many countries, there is a need for implementation of a surveillance policy. There is also room for improvement with regard to the introduction of minimal intervention techniques in practice and public health programs. Dental caries is a marker of social disadvantage, and oral health promotion programs and interventions aimed at reducing the burden of dental caries in LACCs must consider the complexity of the socioeconomic dynamics in this region. There is an urgent need to promote engagement of stakeholders, policymakers, medical personnel, universities, dental associations, community members, and industries to develop regional plans that enhance the oral health agenda for LACCs. A list of recommendations has been presented to underpin strategies aimed at reducing the prevalence and severity of dental caries and improving the quality of life of the impacted LACC population in the near future.

Exostose palatina aberrante / Exostosis palatina aberrante / Aberrant palatal exostosis

RESUMO Introdução: Exostose é um crescimento ósseo benigno que comumente acomete a mandíbula e a maxila, porém raramente apresenta grandes dimensões. Objetivo: Descrever um caso de exostose palatina de apresentação rara e discutir os principais aspectos clínicos envolvidos. Relato de caso: Paciente, gênero masculino, 66 anos, melanoderma, com história de aumento de volume no palato duro com tempo de evolução indeterminado, sem queixas álgicas, porém relatava transtornos de mastigação e fonação. O conjunto da lesão obliterava toda a profundidade do palato e ocupava grande volume na cavidade oral. A Tomografia Computadorizada de Feixe Cônico demonstrava áreas bem corticalizadas na superfície da lesão e áreas centrais menos hiperdensas, compatíveis com osso medular maduro. Após exames e pareceres pós-operatórios o paciente foi submetido a tratamento cirúrgico sob anestesia geral para remoção da massa óssea e osteoplastia subjacente, a fim de dar contornos normais ao palato, e o material colhido foi enviado para a biópsia que estabeleceu o diagnóstico de exostose. O paciente evoluiu sem complicações. Conclusão: Embora a exostose seja um crescimento ósseo benigno, ela causou problemas funcionais ao paciente, necessitando assim de um tratamento cirúrgico. Após três meses da remoção, os distúrbios foram revertidos à normalidade, e a sua reabilitação protética está em andamento(AU)

RESUMEN Introducción: La exostosis es un crecimiento óseo benigno que generalmente afecta la mandíbula y el maxilar, pero rara vez es grande. Objetivo: Describir un caso de exostosis palatina rara y discutir los principales aspectos clínicos involucrados. Presentación del caso: Paciente masculino de 66 años, melanoderma, con antecedentes de aumento de volumen del paladar duro con una evolución de tiempo indefinido, trastornos de masticación y fonación El conjunto de lesiones borró toda la profundidad del paladar y ocupó un gran volumen en la cavidad bucal. La tomografía computarizada de haz cónico mostró áreas corticalizadas en la superficie de la lesión y áreas centrales menos hiperdensas, compatibles con la médula ósea madura. Después de los exámenes y consejos preoperatorios, el paciente se sometió a un tratamiento quirúrgico con anestesia general para eliminar la masa ósea con osteoplastia subyacente a fin de obtener contornos del paladar normales, y el material recolectado fue enviado para realizar biopsia que estableció el diagnóstico de exostosis. El paciente progresó sin complicaciones. Conclusiones: Aunque la exostosis es un crecimiento óseo benigno, causó problemas funcionales al paciente, por lo que requirió tratamiento quirúrgico. Tres meses después de la extracción, los trastornos han vuelto a la normalidad y su rehabilitación protésica está en proceso(AU)

ABSTRACT Introduction: Exostosis is a benign bone growth that commonly affects the jaw and maxilla, but is rarely large. Objective: Describe a case of rare palatal exostosis and discuss the main clinical aspects involved. Case presentation: A case is presented of a male 66-year-old dark-skin patient with a history of hard palate enlargement of an indefinite time of evolution, and chewing and phonation disorders. The lesions had obliterated the entire palatal depth and occupied a large section of the oral cavity. Cone beam computed tomography revealed corticalized areas on the surface of the lesion and less hyperdense central areas compatible with mature bone marrow. After preoperative examination and advice, the patient underwent surgical treatment under general anesthesia to remove the bone mass and underlying osteoplasty to obtain normal palatal contours. The material collected was sent for biopsy testing, which established the diagnosis of exostosis. The patient recovered without any complications. Conclusions: Although exostosis is a benign bone growth, in this case it caused functional problems to the patient, thus requiring surgical treatment. Three months after removal, the disorders have been reverted to normal and prosthetic rehabilitation is underway(AU)

Conhecimento, imunização contra hepatite B e uso das medidas de biossegurança por estudantes da área da saúde em uma universidade no interior de Minas Gerais, Brasil / Knowledge, immunization against hepatitis B and use of biosafety measures by students of the health area at a University in the interior of Minas Gerais, Brazil / Conocimiento, imunización contra hepatites B y uso de las medidas de bioseguridad por estudiantes del área de la salud em uma Universidad em el interior de Minas Gerais, Brasil

Justificativa e Objetivo: O vírus da hepatite B tem alta prevalência mundial, com forte impacto na saúde pública, o que justifica as estratégias de vigilância e prevenção dos possíveis agravos. O risco da exposição ao vírus entre os estudantes e profissionais de saúde constitui uma grande preocupação mostrando-se baixa a adesão desse público as medidas de biossegurança. O objetivo foi avaliar o conhecimento, imunização contra hepatite B e uso das medidas de biossegurança por estudantes da área da saúde em uma universidade no interior de Minas Gerais, Brasil. Métodos: Estudo transversal, descritivo, com aplicação de questionário, de autopreenchimento, a estudantes da área da saúde composto por variáveis sociodemográficas e referentes ao tema biossegurança. Resultados: Dentre os 540 estudantes que participaram do estudo, 37,2% declararam não ter conhecimento sobre biossegurança, e desse total, 28,9% não foram vacinados contra a hepatite B, 32,4% dos estudantes consideraram que não estavam expostos ao vírus da hepatite B, e desses 25,7% não eram vacinados. Ainda o estudo mostrou que 13,3% dos estudantes não usavam luvas e destes 41,7% não eram vacinados. Conclusão: Verificou-se que existem lacunas em relação ao conhecimento e uso das medidas de biossegurança, entre estas, a falha da imunização contra hepatite B. Neste sentido, faz-se necessária a adoção de políticas de educação permanente com inclusão sistemática do tema biossegurança e adoção de mecanismos que garantirão a imunização desses estudantes.(AU)

Rationale and Objective: The hepatitis B virus has a high global prevalence, with a strong impact on public health, which justifies strategies for surveillance and prevention of possible diseases. The risk of exposure to the virus among students and health professionals is a major concern showing that public adherence to biosafety measures is low. The objective was to evaluate knowledge, immunization against hepatitis B and use of biosafety measures by students of the health area at a university in the interior of Minas Gerais. Methods: Cross - sectional, descriptive study with self - filling questionnaires to health students composed of sociodemographic variables and about biosafety. Results: Of the 540 students who participated in the study, 37.2% declared that they did not know about biosafety, and of that total, 28.9% were not vaccinated against hepatitis B, 32.4% of the students considered that they were not exposed to biosafety hepatitis B virus, and of these 25.7% were not vaccinated. Still the study showed that 13.3% of the students did not use gloves and of these 41.7% were not vaccinated. Conclusion: It was verified that there are gaps in the knowledge and use of biosafety measures, among them, the failure of immunization against hepatitis B. In this sense, it is necessary to adopt policies of permanent education with systematic inclusion of biosafety and the adoption of mechanisms that will guarantee the immunization of these students.(AU)

Justificación y Objetivos: El virus de la hepatitis B tiene alta prevalencia mundial, con fuerte impacto en la salud pública, lo que justifica las estrategias de vigilancia y prevención de los posibles agravios. El riesgo de exposición al virus entre los estudiantes y los profesionales de la salud constituye una gran preocupación por la baja de la adhesión de este público a las medidas de bioseguridad. El objetivo fue evaluar el conocimiento, inmunización contra hepatitis B y el uso de las medidas de bioseguridad por estudiantes del área de la salud en una universidad en el interior de Minas Gerais. Métodos: Estudio transversal, descriptivo, con aplicación de cuestionario, de auto-relleno, a estudiantes del área de salud compuesto por variables sociodemográficas y sobre el tema bioseguridad. Resultados: Entre los 540 estudiantes que participaron en el estudio, el 37,2% declaró no tener conocimiento sobre bioseguridad, y de ese total, el 28,9% no fueron vacunados contra la hepatitis B, el 32,4% de los estudiantes consideró que no estaban expuestos al riesgo, virus de la hepatitis B, y de ese 25,7% no eran vacunados. Aún el estudio mostró que el 13,3% de los estudiantes no usaban guantes y de los 41,7% no eran vacunados. Conclusión: Se verificó que existen lagunas en relación al conocimiento y uso de las medidas de bioseguridad, entre éstas, el fallo de la inmunización contra hepatitis B. En este sentido, se hace necesaria la adopción de políticas de educación permanente con inclusión sistemática del tema bioseguridad y la adopción de mecanismos que garantizarán la inmunización de esos estudiantes.(AU)

External control of water fluoridation in a small municipality of northeast of Brazil / Heterocontrole da fluoretação das águas em um município de pequeno porte no nordeste do Brasil

Abstract Introduction Fluoridation of public water supply is an important measure in the prevention of dental caries. Objective This study aimed to monitor the fluoride (F) concentrations of a public water supply with water fluoridation program in a small municipality in the Northeast region of Brazil. Material and method It is a quantitative study with a descriptive approach. Three points of the urban area were selected for collecting water samples twice a month for 12 months. The average of F concentrations was calculated considering these three samples of each collection point at the same occasion. F concentrations in the water samples were determined by potentiometry and the results were classified according to the criterion proposed by criterion set down by Collaborating Center of the Brazilian Ministry of Health for Oral Health Surveillance. The samples were classified according to the best risk-benefit adjustment (0.55 - 0.84 mg F /L). Result Less than 10% of the samples were within the ideal range. Conclusion It was observed that water fluoridation in this municipality was interrupted since many water samples showed f-levels below the minimal acceptable values.

Resumo Introdução A fluoretação das águas de abastecimento público é uma medida importante na prevenção à cárie dentária. Objetivo O objetivo do presente estudo foi avaliar e monitorar os teores de flúor nas águas de abastecimento público em um município de pequeno porte no Nordeste do Brasil. Material e método O estudo apresenta uma abordagem quantitativa de caráter descritivo. Foram selecionados 3 pontos para realizar coleta das águas duas vezes no mês na zona urbana do município durante 12 meses. A concentração de flúor foi obtida pela média das três leituras das amostras analisadas para cada ponto de coleta e classificadas conforme critério proposto pelo Centro Colaborador do Ministério da Saúde em Vigilância da Saúde Bucal. Resultado Segundo o critério utilizado (0,55 - 0,84 mg/L F), apenas 9,7% das amostras estavam dentro do considerado ideal. Conclusão Observou-se que a fluoretação das águas nesse município foi interrompida, pois muitas amostras de água apresentaram níveis de flúor abaixo dos valores mínimos aceitáveis.

Investigation of the Erosive Potential of Different Types of Alcoholic Beverages

Abstract Objective: To evaluate the erosive potential of different alcoholic beverages according to pH, titratable acidity and buffering capacity. Material and Methods: Thirteen industrialized alcoholic beverages of different brands were selected and divided into five groups according to their type and composition. The pH measurement and titratable acidity for pH 5.5 and 7.0 were performed in triplicate in 50 mL of each beverage. The buffering capacity was calculated based on pH and titratable acidity for pH 7.0. ANOVA, Tukey, and Pearson correlation, with p<0.05, were used for data analysis. Results: Data showed normal distribution by Shapiro-Wilk test. The pH of alcoholic beverages ranged from 2.49 (Miks Ice Tea - Green Fruits) to 7.64 (Smirnoff). The highest values of acid titration (4.68) and buffer capacity (19.97) were observed in Smirnoff Ice. The following correlations (p<0.01) were noted between: pH and titratable acidity; buffering capacity and pH; buffering capacity and titratable acidity. Conclusion: Some beers and alcopops presented erosive potential due to their lower pH associated with high acid titration values. The whisky and sugarcane liquor examined were not potentially erosive.

Cariology education for undergraduate Brazilian dental students / Ensino da cariologia para estudantes de graduação em odontologia no Brasil

ABSTRACT This study sought to provide an overview of current cariology education for undergraduate Brazilian dental students. Data collection was via a Portuguese version of a 12-item questionnaire (Schulte et al., 2011) that was sent to all Brazilian dental schools (n = 219). The response rate was 57.0% (n = 125). Of the schools that returned the questionnaire, 84.8% supported the development of a Brazilian cariology curriculum. The units responsible for teaching cariology were predominantly operative dentistry (49.6%), pediatric dentistry (49.6%), dental public health (44.8%), and cariology (32%). Theoretical teaching of cariology (74.4%) and pre-clinical exercises (63.2%) were cited to occur mainly during the second year of the course, while clinical activities were placed in the third (71.2%) and fourth (64.8%) years. Among respondents, 76.8% of the schools included dental erosion and 86.4% included defects of dental hard tissues, such as abrasion, in teaching cariology. This survey was able to determine the panorama of cariology education in Brazil and to detect some differences among Brazilian geographic areas. The promotion of a workshop to discuss the topics that should be taught to undergraduate dental students and the development of a Brazilian core curriculum in cariology would be likely to reduce the differences in teaching cariology in Brazil.

RESUMO Este estudo teve como objetivo apresentar um panorama do ensino de cariologia nos cursos de graduação em Odontologia no Brasil. A coleta de dados foi realizada por meio de uma versão em Português Brasileiro de um questionário de 12 itens (Schulte et al., 2011) que foi enviado a todas as faculdades de Odontologia brasileiras (n = 219). A taxa de resposta foi de 57,0% (n = 125). Dentre as faculdades que responderam o questionário, 84,8% apoiam o desenvolvimento de um currículo brasileiro de cariologia. As disciplinas responsáveis por lecionar os conteúdos de cariologia são principalmente dentística (49,6%), odontopediatria (49,6%), saúde bucal coletiva (44,8%), e cariologia (32%). O ensino teórico de cariologia (74,4%) e os exercícios de pré-clínica (63,2%) são abordados principalmente durante o segundo ano do curso, enquanto as atividades clínicas ocorrem, em geral, no terceiro (71,2%) e quarto (64,8%) anos. Dentre os respondentes, 76,8% das faculdades incluem erosão dentária e 86,4% incluem defeitos dos tecidos dentários duros, como abrasão, no ensino da cariologia. Essa pesquisa foi capaz de determinar o panorama do ensino da cariologia no Brasil e detectar algumas diferenças de currículo entre as regiões do país. A promoção de um workshop para discutir os assuntos que devem ser ministrados aos estudantes de graduação em Odontologia e para desenvolver um currículo brasileiro de cariologia seria válida para reduzir as diferenças no ensino de cariologia no Brasil.

Análise de espécies bacterianas em telefones públicos do centro da cidade de Caruaru ­ PE / Analysis of bacterial species in public telephones in the city center of Caruaru ­ PE

Introdução: os aparelhos de telefones públicos representam importantes agentes disseminadores de infecções por se tratarem de objetos frequentemente manipulados por grande número de pessoas em trânsito das mais diversas regiões. Considerando que a pele humana contém uma microbiota típica e a manipulação de objetos pode propiciar o deslocamento de microrganismos, os aparelhos de telefone podem transmitir doenças através desses agentes. Objetivo: analisar a variedade de espécies bacterianas nos fones de ouvido dos aparelhos de telefones públicos localizados no centro da cidade de Caruaru-PE (Brasil). Metodologia: foram coletados esfregaços dos fones de ouvido, especificamente da região auricular, de 77 telefones públicos do centro da cidade de Caruaru. O material foi colhido com swab estéril e transportado em meio BHI ao Laboratório de Práticas da Saúde da Associação Caruaruense de Ensino Superior, onde foram realizadas cultura e identificação dos agentes bacterianos. Resultados: em todas as amostras foram encontradas bactérias, havendo um predomínio de Staphylococcus coagulase negativa (50,64%), seguido de Bacillus subtilis (27,27%), como também houve presença de Bacillus sp. (28,57), Staphylococcus aureus (18,18%), Enterococcus sp. (2,59), Streptococus do grupo viridans (1,29) e Streptococus sp. (1,29). Conclusão: Há grande diversidade de espécies bacterianas nos fones de ouvido dos telefones públicos do Centro de Caruaru.

Introduction: public telephones represent important dissemination agents because they are objects varied by large numbers of people in transit from the most diverse regions. Consider that a human skin contains a typical microbiota and a manipulation of objects can propitiate the displacement of microorganisms, telephone devices can transmit diseases through agents. Objective: To analyze a variety of bacterial species in the headsets of public telephone sets located in the city of Caruaru-PE (Brazil). Methods: Smears were collected from the earphones, specifically from the auricular region, from 77 public telephones in the city center of Caruaru. The material was collected with sterile swab and transported in BHI medium to the Laboratory of Health Practices of the Caruaruense Association of Higher Education, where culture and identification of bacterial agents were carried out. Results: Staphylococcus coagulase negative (50.64%), followed by Bacillus subtilis (27.27%), were also found in all samples, as well as the presence of Bacillus sp. (28,57), taphylococcus aureus (18.18%), Enterococcus sp. (2,59), Streptococus do grupo viridans (1,29) and Streptococus sp. (1,29). Conclusion: There is a great diversity of bacterial species in the headsets of the public telephones of the Center of Caruaru.

Dental fluorosis treatment can improve the individuals' ohrqol? results from a randomized clinical trial

Abstract This study aimed to evaluate the effect on oral health-related quality of life (OHRQoL) of two treatment protocols for dental fluorosis in individuals enrolled in a randomized clinical trial. Seventy volunteers, who lived in a fluorosis endemic area in Brazil, and had at least four maxillary anterior teeth showing fluorosis with a Thylstrup and Fejerskov index from 1 to 7, were randomized into two treatment groups (n= 35): GI- enamel microabrasion; or GII- microabrasion associated with at-home bleaching. Microabrasion was performed using 37% phosphoric acid and pumice, and at-home tooth bleaching with 10% carbamide peroxide in a tray. Volunteers completed a questionnaire at baseline and 1-month post treatment to assess changes in OHRQoL, using the Oral Impact on Daily Performance (OIDP). Differences in overall impact scores between and within treatment groups were analyzed with Wilcoxon (within) and Mann-Whitney (between) tests. Changes in performance scores were analyzed using Wilcoxon tests (a< 0.05). One month after treatment, subjects reported improvement in OHRQoL. Both groups showed lower OIDP scores (p< 0.001), but there was no difference between them. Eating, cleaning teeth, smiling and emotional state performance scores were lower after treatment for the whole sample. In conclusion, the treatment with microabrasion improved the OHRQoL in this sample of individuals living in a fluorosis endemic area regardless of the addition of at-home bleaching.

Resumo Este estudo teve como objetivo avaliar o efeito na qualidade de vida relacionada à saúde bucal (QVRSB) de dois protocolos de tratamento para fluorose dentária, em indivíduos incluídos em um ensaio clínico randomizado. Setenta voluntários, os quais viviam em uma área de fluorose endêmica no Brasil, e que possuíam pelo menos quatro dentes ântero-superiores com índice de Thylstrup e Fejerskov de 1 a 7, foram randomizados em dois grupos de tratamento (n= 35): GI- microabrasão de esmalte; ou GII- microabrasão associada com clareamento caseiro. A microabrasão foi realizada com ácido fosfórico 37% e pedra pomes e, o clareamento caseiro com peróxido de carbamida 10% e uso de moldeira. Os voluntários responderam um questionário antes e 1 mês após o tratamento, visando avaliar mudanças na QVRSB através do instrumento Oral Impact on Daily Performance (OIDP). Diferenças nos escores de impacto geral entre e nos mesmos grupos de tratamento foram analisadas através dos testes Wilcoxon (mesmo grupo) e Mann-Whitney (entre grupos), respectivamente. Alterações no escores dos domínios foram analisadas usando o teste Wilcoxon (a<0.05). Um mês após o tratamento, os indivíduos relataram melhora na QVRSB. Ambos os grupos apresentaram menores escores do OIDP (p<0,001), sem diferença entre eles. Os escores dos domínios comer, limpar os dentes, sorrir e estado emocioal diminuíram após o tratamento para toda a amostra. Concluiu-se que o tratamento com microabrasão melhorou a QVRSB de indivíduos vivendo em uma área de fluorose endêmica independentemente da associação com o clareamento caseiro.

AgNPs: The New Allies Against S. Mutans Biofilm - A Pilot Clinical Trial and Microbiological Assay

Abstract: The purpose of this study was to evaluate the antimicrobial properties of a new formulation containing silver nanoparticles, named Nano Silver Fluoride (NSF), to inhibit Streptococcus mutans biofilm formation on children's dental enamel. The variations in dental biofilm pH and in the Simplified-Oral-Hygiene-Index (OHI-S) also were evaluated after the treatment with NSF. This was a randomized, double-blind, crossover and prospective pilot clinical trial study in which 12 schoolchildren, aged between 7-8 years, had their dental enamel treated with two solutions: S1 - Nano Silver Fluoride and S2 - negative control (saline solution), in different experimental moments. The dental biofilm adhered to enamel treated with NSF had lower values of S. mutans viability (absorbance) and colony forming units (CFU) than the S0 (baseline) and S2. There was a statistically significant difference between the OHI-S mean values of S0 and S1. There were no differences between the biofilm pH (both before and after the use of the test substances) and among the different groups. These properties suggest that NSF has bactericidal effect against S. mutans biofilm and it may be used for clinical control and prevention of dental biofilm formation.

Resumo O objetivo do presente estudo foi avaliar as propriedades antimicrobianas de uma nova formulação composta por nanopartículas de prata, denominada nano silver fluoride (NSF), na inibição de biofilme de Streptococcus mutans sobre a superfície do esmalte dentário de crianças. Variações no pH do biofilme dental e nos valores do índice de Higiene Oral Simplificada (IHO-S) também foram avaliadas após o tratamento com NSF. Trata-se de um estudo piloto, randomizado, duplo cego, cruzado e prospectivo. A amostra foi composta por 12 crianças, de ambos os gêneros, com idades entre 7 e 8 anos, as quais utilizaram as duas soluções testes, S1- NSF e S2- controle negativo (solução salina). O biofilme dental tratado com NSF apresentou menores valores de viabilidade de S. mutans (absorbância) e de unidades formadoras de colônias (UFC) do que o biofilme baseline e o biofilme tratado com S2. Houve diferença estatisticamente significativa entre os valores médios de IHO-S dos grupos baseline e S1, com uma redução dos valores. Não houve qualquer variação nos valores de pH do biofilme dental, antes e depois do tratamento com S1 e S2 e entre os diferentes grupos. Estas propriedades sugerem que NSF possui efeito bactericida sobre o biofilme de S. mutans, podendo ser utilizado clinicamente para o controle e prevenção da formação do biofilme dentário.