Salud bucodental materno-infantil. ¿Podemos mejorarla? / Maternal and infant oral health care. How do we improve it?

INTRODUCCIÓN: La caries dental es la enfermedad infecciosa más prevalente entre las afecciones crónicas del niño y resulta especialmente grave en los menores de 3 años. Considerando que la salud oral de la madre está directamente relacionada con la de su hijo, el papel de los profesionales que asisten a las mujeres y a sus hijos durante los primeros años de vida es fundamental para la prevención de estas enfermedades. OBJETIVO: Proponer pautas actualizadas para mejorar la salud bucodental de gestantes y niños en la primera infancia. MATERIAL Y MÉTODO: Búsqueda de información sobre salud oral de la gestante y del niño en la primera infancia en las bases MedlinePlus, PubMed y Cochrane Library, y en guías de salud de diferentes sociedades científicas. RESULTADOS: Entre las principales pautas para mejorar la salud oral materno-infantil se incluyen las siguientes: revisión odontológica y profilaxis en la mujer gestante, uso de flúor tópico en lactantes mayores de 10 meses con alto riesgo de caries, abandono del biberón y chupete como máximo a los 2 años, evitar hábitos de transmisión salival madrehijo, introducir lo más tarde posible los azúcares refinados, evitar el picoteo frecuente (sólido o líquido), usar pasta dental fluorada estándar desde la erupción dental y visita odontológica al año de edad del niño. CONCLUSIÓN: La guía de salud bucal propuesta está basada en la evidencia científica actualizada, y establece pautas comunes para todos los profesionales sanitarios, entre los cuales la matrona desempeña un papel primordial en la prevención

INTRODUCTION: Dental caries is the most infectious prevalent chronic disease in childhood and it's especially severe in children younger than three years old. However, it is a highly preventable disease if some recommendations are followed. Considering that the mother's oral health is directly related with that of her children's, the role of health professionals who assist women and children during their first years of life, is very important on the prevention of the disease. AIM: The aim of this review is to propose guidelines to improve the oral health of pregnant women and children in early childhood. MATERIAL AND METHODS: A research on MedlinePlus, PubMed and Cochrane Library databases was done focusing on pregnant women and infants' oral health. Oral health guidelines of different scientific academies were also consulted. RESULTS: Oral health guidelines for the mother-child pair include: dental exam and prophylaxis for the pregnant woman, use of topical fluoride in breastfed infants older than 10 months old with high caries risk, weaning from the baby bottle and pacifier at 2 years of age, avoiding salivasharing activities, delayed introduction of refined sugars, avoiding constant grazing (solid or liquid), use of standard fluoridated toothpaste since the time of dental eruption and a first dental visit at age one. CONCLUSION: The proposed oral health guideline is based on current scientific evidence and it is common for all the healthcare professionals. The midwife plays a very important role in caries prevention

A fused maxillary central incisor and its multidisciplinary treatment: an 18-year follow-up.

Fused teeth may cause aesthetic, spacing, periodontal, eruption, and caries problems. The present case report describes a 7-year-old boy patient with a chief complaint of unerupted maxillary incisor. Radiographic examination indicated a fused tooth which had two fused roots but two independent root canals. A complex management of a fused tooth is really difficult to standardize. In this case an orthodontic, endodontic, and surgical treatment (intentional replantation) allowed the tooth to be retained until 18 years following intervention. Maintenance of the root and alveolar bone in young adults at least until full skeletal maturation should be the main treatment objective.

Pautas para la salud bucal en los primeros años de vida / Guidelines for oral health during early childhood

La caries es una enfermedad infecciosa crónica de marcada prevalencia en niños de diferentes países del mundo. Sin embargo, es una enfermedad potencialmente prevenible si se controlan los factores de riesgo que la ocasionan. Estos factores etiológicos pueden ser influenciados por los padres y los profesionales que asisten alniño y su entorno, siempre y cuando se tengan los conocimientos adecuados sobre las pautas de salud bucal. Por ello creemos que es indispensable la elaboración de una guía integral para uniformar los criterios y orientaciones enlo que se refiere a la salud bucal en la primera infancia, con el fin de proveer una información única a los padres de nuestros pacientes y no generar conflictos de información. Objetivo: Esta guía de salud bucal para los primeros años de vida es una propuesta para esclarecer y definir algunos puntos en común desde el punto de vista de la salud bucal. De esta forma, los padres tendrán más seguridad sobre el cuidado bucodental de sus hijos si poseen la misma información de todos los profesionales. Se plantean temas como la lactancia materna, el uso del biberón y del chupón, la transmisión bacteriana precoz, los alimentos con potencial cariogénico, la higiene bucal, el uso de flúor y la primera visita al odontopediatra. Conclusión: Como odontopediatras, sabemos que la instauración de una educación precozes una estrategia clave para evitar una necesidad futura y que toda la información de salud oral debe ser uniforme y estar consensuada por los diferentes profesionales que trabajan con el niño. Estas pautas de salud oral, basadas en la evidencia actual, son una propuesta para estandarizar criterios, los cuales se basan en la salud y no en la enfermedad.

Dental caries is a prevalent and chronic infectious disease in children across the world. However, it can be potentially prevented if the risk factors are controlled. Parents and health care professionals that assist the child can influence the different etiological factors implied in the caries process, provided that correct knowledge about oral health is available. Therefore, it seems imperative to elaborate a healthcare guide to standardize recommendations and guidance concerning oral health in early childhood,so that parents receive standardized information concerning their childrenÆs oral health. Objective: This oral health guideline for the first years of life aims to clarify and define some commonissues concerning oral health. In this way, parents will feel more secure if they hear the same information from all health care professionals. Issues such as breastfeeding, bacterial transmission, use of pacifiers and baby bottles, diet, oral hygiene, use of fluoride and the firstdental visit are discussed. Conclusion: As pediatric dentists, we know that the establishment of an early education isa key strategy to avoid a future need. All oral health education should be standardized and agreed upon by all professionals working with children. This oral health guideline, based oncurrent evidence, is a proposal to standardize criteria, which is based on health rather than disease.

Clinical management of regional odontodysplasia.

Regional odontodysplasia (ROD) is a rare, localized developmental anomaly of the dental tissues with distinctive clinical, radiographic, and histologic findings. The purpose of this study was to describe the characteristics and clinical management of 2 patients diagnosed with ROD at the Pediatric Dentistry Service at the Hospital Sant Joan de Déu, Barcelona, Spain. In both cases, temporary and permanent dentition were involved. It was concluded that therapeutic decisions during childhood must be based on the degree of involvement and each case's functional and aesthetic needs. Autotransplantation may be a good partial treatment option during the period of mixed dentition in some cases. Definitive treatment will include prosthetic rehabilitation with implants once the patient reaches adulthood.

Oral manifestations in Ellis-van Creveld syndrome: report of five cases.

Ellis-van Creveld syndrome, or chondroectodermal dysplasia, is an autosomal recessive disorder with characteristic clinical manifestations. Its incidence in the general population is low. The oral manifestations of Ellis-van Creveld are found in soft tissues and teeth, but the dental literature on the subject is scarce. In the last 20 years, 5 cases of Ellis-van Creveld syndrome have been followed at the Pediatric Dentistry Service of the Hospital Sant Joan de Déu, Barcelona. The present study describes the constant and variable oral findings in these patients, which play an important role in the diagnosis criteria for the syndrome. The presence of a great variety of oral manifestations such as fusion of the upper lip to the gingival margin, presence of multiple frenula, abnormally shaped and microdontic teeth, and congenitally missing teeth requires multidisciplinary dental treatment, with consideration for the high incidence of cardiac defects in these patients.

Failure of eruption of first and second permanent molars.

Failure of eruption of permanent molars is an uncommon condition with a range of possible causative factors. This retrospective study of 35 pediatric subjects assesses the influence of these factors in the prognosis. The study aims to broaden our understanding of an abnormality, which has a considerable clinical impact, and proposes a treatment protocol for the management of these patients.