Knowledge of health professionals about breastfeeding and factors that lead the weaning: a scoping review.

This review evaluated the knowledge of health professionals (HP) about breastfeeding and factors that leading the weaning. A search was performed in four electronics databases and the grey literature. The search strategy included Mesh terms and synonyms. No language or date restrictions were adopted. Studies that evaluated the knowledge of HP about breastfeeding and weaning were considered eligible. The studies retrieved by the searches were evaluated by two independently examiners. From 1,417 studies retrieved, 35 were included. Many countries and professionals from different health areas were analyzed. No studies evaluated the dentists' knowledge. Although the included HP know the benefits of breastfeeding for health, the length of breastfeeding recommended by the World Health Organization, exclusive or not, was not aligned with all professionals' endorsement. Information about weaning is scarce; however, HP are mindful of the main potential causes of early weaning. The knowledge of HP is conflicting about breastfeeding and unusual about weaning. Furthermore, no studies were found that presented data on the knowledge of dentists on the subject. Thus, assessments of dentists' knowledge and education measures for HP are necessary since they are frequently questioned about these issues.

Knowledge of health professionals about breastfeeding and factors that lead the weaning: a scoping review / Conhecimento de profissionais de saúde sobre amamentação e fatores que levam ao desmame: uma revisão de escopo

Abstract This review evaluated the knowledge of health professionals (HP) about breastfeeding and factors that leading the weaning. A search was performed in four electronics databases and the grey literature. The search strategy included Mesh terms and synonyms. No language or date restrictions were adopted. Studies that evaluated the knowledge of HP about breastfeeding and weaning were considered eligible. The studies retrieved by the searches were evaluated by two independently examiners. From 1,417 studies retrieved, 35 were included. Many countries and professionals from different health areas were analyzed. No studies evaluated the dentists' knowledge. Although the included HP know the benefits of breastfeeding for health, the length of breastfeeding recommended by the World Health Organization, exclusive or not, was not aligned with all professionals' endorsement. Information about weaning is scarce; however, HP are mindful of the main potential causes of early weaning. The knowledge of HP is conflicting about breastfeeding and unusual about weaning. Furthermore, no studies were found that presented data on the knowledge of dentists on the subject. Thus, assessments of dentists' knowledge and education measures for HP are necessary since they are frequently questioned about these issues.

Resumo Esta revisão avaliou o conhecimento dos profissionais de saúde (PS) sobre amamentação e fatores que levam ao desmame. Realizou-se buscas em quatro bancos de dados eletrônicos e literatura cinzenta. A estratégia de busca incluiu termos Mesh e sinônimos. Não se adotou restrição de idioma ou data. Estudos avaliando o conhecimento dos PS sobre amamentação e desmame foram elegíveis. Estudos recuperados pelas buscas foram avaliados por dois examinadores independentes. Dos 1.417 estudos recuperados, 35 foram incluídos. Muitos países e PS de diferentes áreas foram analisados. Nenhum estudo avaliou o conhecimento dos dentistas. Embora os PS conheçam os benefícios da amamentação, a duração recomendada pela Organização Mundial da Saúde, exclusiva ou não, não está alinhada com o endosso de todos os PS. Considerando o desmame, a informação é escassa. No entanto, os PS estão atentos às principais causas potenciais do desmame precoce. O conhecimento dos PS é conflitante sobre amamentação e incomum sobre o desmame. Não foram encontrados estudos que apresentassem dados sobre o conhecimento de dentistas sobre a temática. Investigações quanto ao conhecimento dos mesmos e medidas de educação para todos os PS são necessárias, considerando que são frequentemente questionados sobre o tema.

Efficacy of sealing occlusal caries with a flowable composite in primary molars: A 2-year randomized controlled clinical trial.

OBJECTIVES: This randomized controlled clinical trial evaluated the efficacy of sealing carious dentin in controlling the progression of lesions in primary molars for 2-year follow-up. MATERIALS AND METHODS: Children (6.79 ±â€¯1.81 years, n = 28) presenting primary molars with occlusal caries in the outer half of dentine were randomized and allocated into 2 groups: test (sealing caries with a flowable resin - SC) and control (partial removal of caries followed by restoration - PRC). The primary outcomes were: the clinical success of restorations evaluated by USPHS criteria and the radiographic analysis of caries progression. The children anxiety was evaluated by a Facial Image Scale; and the time required to perform the treatments was registered. RESULTS: In 21 patients evaluated after 2 years, 48 primary molars were analyzed. Clinically, there was no difference between the groups. There was no difference between treatments (p = 0.848) considering lesion progression. The anxiety level did not change after the two interventions (p = 0.650). The treatment time of SC (9.03 ±â€¯1.91 min) was lower (p = 0.002) than the PRC time (17.13 ±â€¯5.26 min). CONCLUSION: Sealing carious dentin may be used in dentistry since it did not alter the children anxiety, reduced the chair time and demonstrated clinical success rate and no radiographic difference in relation to the partial caries removal followed by restoration.

Influence of the microbiological component of Cariogram® for evaluating the risk of caries in children.

OBJECTIVE: To compare the risk for caries in children as determined by Cariogram® software (CS; Stockholm, Sweden) with and without its microbiological component and by a form based on Cariogram® (FBC). METHODS: Children (n = 28) aged 3-9 years were included. Data were collected clinically and from anamnesis. The salivary levels of Streptococcus mutans (SM) were evaluated. A linear regression model was used to determine which variables were predictive for each type of risk analysis. Caries risk was the dependent variable and the independent variables were caries experience, related disease, plaque amount, diet frequency, salivary levels of SM, fluoride sources and clinical judgment. A paired Student t-test was used for the following comparisons: (a) CS with and without SM; (b) CS without SM and FBC; (c) CS with SM and FBC. RESULTS: The mean dmft/DMFT was 5.56 ± 2.51. There was no difference between the methods (p < .05). Regardless of caries risk, the children presented the same levels of SM (p = .889). Caries experience, plaque amount, diet frequency and fluoride sources were predictors of caries risk in all assessment methods. Clinical judgment was a significant predictor in CS. CONCLUSIONS: Caries experience, plaque amount, diet frequency and fluoride sources are valuable predictors of caries risk; microbiological tests are not necessary for evaluating caries risk in children, which can be assessed similarly by CS without SM and FBC.

Selamento de lesões de cárie em dentina de molares decíduos: estudo clínico controlado e randomizado / Sealing of carious lesions in dentin of deciduous molars: clinical controlled and randomized study

O objetivo do presente estudo foi avaliar a eficácia da técnica de selamento realizada sobre dentina cariada em molares decíduos. Para isto, um ensaio clínico controlado e randomizado foi desenvolvido. Previamente ao ensaio clínico, um estudo para avaliação de método foi realizado. Buscou-se comparar o risco à cárie em crianças (n=28) de 3 a 9 anos de idade, através dos seguintes instrumentos preditores: Cariogram® com análise microbiológica (níveis salivares de Streptococcus mutans - SM) incluída no modelo; Cariogram® sem SM incluído no modelo; e um formulário baseado no Cariogram® também sem a variável SM. Os resultados demonstraram que não houve diferença entre os métodos de avaliação (p>0,05) e que os níveis salivares de SM não foram necessários para avaliação do risco da criança a desenvolver cárie. Diante desses resultados, os sujeitos foram aleatoriamente alocados em dois grupos: principal (STC) e controle (RPTC), levando-se em conta a classificação de risco (baixo, moderado ou alto) à doença. Assim, uma homogeinização dos grupos, quanto à saúde bucal das crianças, foi alcançada. Buscando-se comparar STC com RPTC, os principais desfechos do ensaio foram o sucesso clínico dos selamentos e das restaurações (através do critério USPHS); bem como a presença ou não de progressão de cárie (análise pareada de radiografias interproximais), avaliados por examinadores externos e cegos, ao longo de 1 ano de acompanhamento. A ansiedade das crianças antes e após cada tratamento e o tempo despendido em cada uma das intervenções representaram desfechos secundários. Os níveis salivares de S. mutans, Lactobacillus spp. Candida spp. e Bifidobacterium spp. das crianças, também foram observados e comparados entre os grupos antes e após os tratamentos. Após 1 ano de acompanhamento, 22 crianças foram avaliadas, totalizando 44 dentes com lesões oclusais (1,5mm de diâmetro) até o 1/3 externo de dentina. Clinicamente não houve diferença entre os grupos em relação às restaurações. Apenas um elemento do STC apresentou progressão da lesão após 1 ano, contudo não houve diferença estatística entre os tratamentos (p=0,529). O nível de ansiedade não sofreu alterações significativas antes e após as duas intervenções (p=0,650). A média de tempo de tratamento do STC (9,03 ± 1,91 min) foi estatisticamente menor (p=0,002) que a média do RPTC (17,13 ± 5,26). Em acréscimo, os níveis salivares de todos os microrganismos avaliados não foram diferentes, entre as crianças dos dois grupos, em cada momento de avaliação. Os resultados demonstraram que a técnica de selamento de cárie até 1/3 externo da dentina pode ser indicada em Odontologia, uma vez que não alterou a ansiedade das crianças, reduziu o tempo de cadeira e apresentou uma taxa de sucesso clínico e radiográfico sem diferença estatística em relação à remoção parcial de tecido cariado seguida da restauração (AU)

The aim of this study was to evaluate the efficacy of the sealing technique performed on carious dentin in primary molars. For this, a controlled, randomized clinical trial was developed. Prior to the trial, a study method was executed. Thus, the risk of caries in children (n = 28) aged 3-9 years old was compared by the using of the following predictors instruments: Cariogram® with microbiological analysis (salivary levels of Streptococcus mutans - SM) included in the model; Cariogram® without SM included in the model; and a form based on Cariogram® also without SM variable. The results showed no difference between the assessment methods (p> 0.05) and the salivary levels of SM were not essential to assess the caries risk of children. Taking these results into account, the subjects were randomly divided into two groups: main (SCT) and control (PRCT), considering the risk classification (low, moderate or high) to the disease. Thus a homogenization of the groups was achieved, regarding the caries risk status of children. Seeking to compare SCT with PRCT, the main outcomes of the trial were the clinical success of sealings and restorations (by USPHS criteria); as well as the presence or absence of caries progression (paired analysis of bitewing radiographs), evaluated by blind independent examiners over 1-year follow-up. The anxiety of children before and after each treatment and the time required for each intervention comprised the secondary outcomes. Salivary levels of S. mutans, Lactobacillus spp., Candida spp. and Bifidobacterium spp. were also observed and compared between the groups before and after the treatments. After 1 year of follow up, 22 patients were evaluated, thus 44 teeth with occlusal lesions (1.5 mm diameter) in the outer half of dentin were analysed. Clinically, there was no difference between the groups regarding restorations. Only one molar from SCT showed lesion progression after 1 year, but there was no statistical difference between the treatments (p = 0.529). The anxiety level did not change significantly after the two interventions (p = 0.650). The average treatment time SCT (9.03 ± 1.91 min) was statistically lower (p = 0.002) than the mean of the PRCT (17.13 ± 5.26). In addition, the salivary levels of all target microorganisms were not different between children included in both groups at each assessment point. The results demonstrated that caries sealing technique performed on the outer half of carious dentin may be used in dentistry since it did not alter the children anxiety, reduced chair time and demosntrated clinical success rate and no radiographic statistical difference in relation to the partial caries removal followed by restoration. (AU)