Dental Status of Firefighters of Rio de Janeiro State and Comparison with Brazilian Oral Health Surveys

ABSTRACT Objective: This cross-sectional study aimed to assess clinical dental status in military firefighters of Rio de Janeiro State and compare data with Brazilian National and Regional oral health surveys. Material and Methods: A sample of 926 military firefighters was examined using the visible biofilm index, the DMFT index and the Community Periodontal Index (CPI). Clinical exams were performed by 15 trained dentists. The Kruskal-Wallis test and Mann-Whitney test with Bonferroni correction were used. Results: Higher biofilm accumulation was associated with increased age. The mean DMFT index for the whole sample of this study was 12.74 (±7.03), and the 'filled' component was the most prevalent (69.9%), whereas the 'decayed' and 'missing' components were, respectively, 8.4% and 21.7%. There was a higher prevalence of periodontal diseases with increasing age, ranging from 57.1% in firefighters of 34 years or less to 70.5% in the ones between 35 and 44 years old and 75.4% in participants at age 45 years or older. Clinical dental status of the military firefighters who belonged to the age group 35-44 was better than the one observed for the Brazilian population at the same age range. However, pathological conditions that can be solved with health promotion strategies associated with dental procedures of low complexity still persist. Conclusion: These results suggest that the availability of dental health care services itself does not represent the most effective approach to the oral health problems found in the studied population.

Does the Presence of Sucrose in Pediatric Antibiotics Influence the Enamel Mineral Loss and the Streptococcus mutans Counts in Dental Biofilm?

The role of antibiotics containing sucrose on the formation of dental caries is still controversial. This study aimed to investigate the effect of two antibiotics (amoxicillin and potassium clavulanate suspension), with and without sucrose, on human dental hardness and Streptococcus mutans counts in dental biofilm. Primary tooth fragments (n=72) were coated with nail varnish leaving a window of 2.25 mm diameter. Specimens were fixed in 24-well polystyrene plates, containing BHI medium. S. mutans (clinical strains) represented the inoculum to form biofilm on the fragments for 24 h. Twelve fragments were separated for the initial count of microorganisms (baseline). The other fragments were divided into 4 groups (n=12) of treatment: G1 (Clavulin(r)), G2 (Betamox(r)), G3 (chlorhexidine 0.12%), G4 (sucrose 10%). All specimens had their self-control area (covered area). The cross-sectional microhardness (CSMH) was evaluated for each specimen. All the treated groups had a loss of hardness compared to their self-controls (p<0.05). Both drugs inhibited the S. mutans growth and promoted no CSMH difference among them. Both antibiotics eliminated all formed biofilm and did not cause mineral loss from the enamel, regardless the presence of sucrose in its formulation.

O papel dos antibióticos contendo sacarose na formação de cárie dentária é ainda controverso. Este estudo teve como objetivo investigar o efeito de dois antibióticos (amoxicilina / clavulanato de potássio suspensão oral), com e sem sacarose, na dureza do esmalte dental humano e na contagem de Streptococcus mutans no biofilme dental. Fragmentos de dentes decíduos (n = 72) foram revestidos com verniz deixando uma janela de exposição de 2,25mm de diâmetro. Os espécimes foram fixados em placas de poliestireno de 24 poços, contendo meio de cultura BHI. S. mutans (estirpes clínicas) representaram o inoculo para formar biofilmes sobre os fragmentos por 24 h. Doze fragmentos foram separados para a contagem inicial de microrganismos (baseline). Os restantes dos fragmentos foram divididos em 4 grupos (n = 12) de tratamento: G1 (Clavulin(r)), G2 (Betamox(r)), G3 (clorexidina 0,12%), G4 (sacarose a 10%). Todas as amostras tiveram sua área de controle (área coberta). A microdureza transversal (CSMH) foi avaliada para cada espécime. Todos os grupos tratados tiveram uma perda de dureza quando comparados com os seus respectivos controles (p <0,05). Ambos os fármacos inibiram o crescimento de S. mutans e não promoveram diferença da CSMH entre eles. Ambos os antibióticos eliminaram todo o biofilme formado, não promovendo assim, perda mineral do esmalte, independente da presença de sacarose na sua formulação.

Erosive effect of an antihistamine liquid formulation on bovine teeth: influence of exposure time

Aim: To evaluate, in vitro, the effect of an oral antihistamine liquid formulation on roughness and topography of bovine enamel and the influence of exposure time on its erosive effect. Methods: Forty-one bovine enamel blocks were prepared leaving an exposed window of 0.8 mm2 Thirtynine blocks were divided into three treatment groups according to media immersion: antihistamine. formulation (Histamin ®), 0.6% citric acid (positive control), and distilled water (negative control). Before immersion of the samples, pH, titratable acidity, calcium, phosphate and fluoride contents of all media were verified. Enamel roughness was evaluated at baseline, and after 5, 15, and 30 min of immersion (9 samples per group). Two specimens from each group and exposure time, and 2 additional specimens representing baseline, were analyzed by scanning electron microscopy (SEM). Data were analyzed by the Kruskal-Wallis test, and the Mann-Whitney test using the Bonferroni correction (á=0.017). Results: Specimens immersed in citric acid showed the highest roughness (P<.001). SEM images showed a progressive erosion pattern in samples immersed in citric acid and in antihistamine formulation. Conclusions: The antihistamine liquid formulation did not promote significant alterations of enamel roughness. Nevertheless, SEM demonstrated that the antihistamine eroded bovine enamel, and the erosion pattern was influenced by exposure time.

Percepções e atitudes de responsáveis por crianças frente ao uso de medicamentos infantis e sua relação com cárie e erosão dentária / Perceptions and attitudes among parents and guardians on the use of pediatric medicines and their cariogenic and erosive potential

Este estudo avaliou as percepções e atitudes de responsáveis por crianças sobre os potenciais cariogênico e erosivo de medicamentos infantis. Foram realizadas entrevistas sobre a associação do uso de medicamentos infantis com cárie e erosão dentária, bem como os cuidados com a higiene bucal após sua ingestão. Do total de responsáveis com entrevista completa (n=86), 24 (27,9 por cento) consideraram os medicamentos infantis ácidos, 51 (59,3 por cento) amargos e 56 (65,1 por cento) doces; porém, apenas 16 (28,6 por cento) destes últimos realizavam higiene bucal das crianças após utilização (Exato de Fisher; p>0,05). Além disso, apenas 18 (20,9 por cento) responsáveis realizavam esta prática, dos quais 8 (44,4 por cento) haviam recebido orientação prévia sobre higiene bucal (Exato de Fisher; p<0,05). A associação entre uso de medicamentos e cárie dental ou defeitos na estrutura dos dentes foi apontada por 61 (70,9 por cento) entrevistados, dos quais 24 (39,3 por cento) justificaram tal associação em função da presença de açúcar nas formulações. Apesar dos responsáveis considerarem os medicamentos doces e relacionarem seu uso à presença de cárie e defeitos na estrutura dental, grande parte destes não realiza higiene bucal em seus filhos após o uso desses fármacos e não consegue estabelecer claramente a relação de causa e efeito existente em tal associação.

The study assesses the perceptions of parents/guardians on the use of pediatric medicines and their cariogenic/erosive potential, interviewing them on the relationship between the use of pediatric medicines and cavities/dental erosion, as well as oral hygiene procedures after the medication. Among the interviewed parents/guardians (n=86), 24 (27.9 percent) mentioned the sour taste of pediatric medication, 51 (59.3 percent) the bitter taste, and 56 (65.1 percent) considered them sweet, although only 16 (28.6 percent) of these parents/guardians brushed their children's teeth after the medication (Fisher's Exact; p>0.05). Moreover, only 18 (20.9 percent) of the parents/guardians performed oral hygiene practices after the medication, of whom 8 (44.4 percent) received previous instructions (Fisher's Exact; p<0.05). The association between taking medications and dental caries or structural dental defects was mentioned by 61 (70.9 percent) of the parents/guardians, with 24 (39.3 percent) of them justifying this association through the presence of sugar in the formulations. Although parents/guardians consider medicines to be sweet substances and relate their use to dental caries and tooth structure flaws, most of them do not brush their children's teeth after taking medications and are unable to establish a clear cause/effect relationship for this association.

O tratamento restaurador atraumático no contexto do Sistema Único de Saúde / Atraumatic restorative treatment regarding the context of Sistema Único de Saúde

Este trabalho tem por objetivo analisar o Tratamento Restaurador Atraumático - TRA como estratégia de ação clínica da Odontologia dentro do Sistema Único de Saúde - SUS. Além disto, alguns aspectos como o uso de tecnologia apropriada, o baixo custo e o amplo respaldo científico do TRA são salientados como seus principais pontos positivos. São também apontados os benefícios e as possibilidades de aplicação do TRA no contexto do Programa Saúde da Família, bem como nos diferentes espaços sociais, objetivando a universalização da atenção odontológica. Por fim, o artigo salienta a necessidade de implementação de políticas econômicas e sociais mais justas como fator essencial para a melhoria da saúde bucal da população brasileira.

This paper intends to both analyze the Atraumatic Restorative Treatment - ART as a strategy of clinical action of Dentistry in the Sistema Único de Saúde - SUS, and emphasize some of its aspects, such as appropriate technology usage, low cost and the vast scientific support, as its main positive characteristics. We also emphasize the benefits of the ART in the context of Programa Saúde da Familia (PSF) and its possibilities of application to the public in different social spaces, in order to achieve the universalization of the dental attention. ln conclusion, the paper stresses the necessity to implement fair social and economic policies as essential factors for the improvement of Brazilian population's oral health.