Should We Wait to Brush Our Teeth? A Scoping Review Regarding Dental Caries and Erosive Tooth Wear.

BACKGROUND: Tooth brushing is a universal recommendation. However, the recommendations related to the time of its execution are conflicting, especially when dealing with patients at risk of erosive tooth wear (ETW) or dental caries. SUMMARY: Our objective was to summarize the evidence on the timing of brushing with fluoridated toothpaste in relation to ETW and cariogenic dietary challenges. We conducted a scoping review following the PRISMA-ScR checklist, using three databases searching for in vivo, in situ, or in vitro studies involving human teeth exposed to either a cariogenic or an erosive challenge. Only models including human saliva and fluoride were assessed. Data selection, extraction, and risk of bias analysis were done in duplicate and independently. From 1,545 identified studies, 17 (16 related to ETW and 1 to dental caries) were included. Most evidence (n = 10) supported that brushing with a fluoride-containing product does not increase ETW, independent of the moment of brushing. Delaying tooth brushing up to 1 h (n = 4) or individualized recommendations based on the patient's problem (n = 2) were less frequent. Only one study reported that brushing pre- or post-meal does not affect Streptococcus mutans counts. Most data were in situ (n = 13), and the overall study quality was judged as sufficient/low risk of bias. KEY MESSAGES: Although the available evidence lacked robust clinical studies, tooth brushing using fluoridated products immediately after an erosive challenge does not increase the risk of ETW and can be recommended, which is in line with recommendations for dental caries prevention. Furthermore, we suggest updating the international guidelines to promote individualized recommendations based on risk factors to prevent either ETW or dental caries.

The effect of phytosphingosine associated with tooth brushing on color change, surface roughness, and microhardness of dental enamel - an in vitro and in situ study.

OBJECTIVE: This study evaluated the in vitro and in situ effects of phytosphingosine (PHS) associated with tooth brushing on color stability, surface roughness, and microhardness of dental enamel. METHODS: Sixty-four specimens of bovine teeth (6 × 6 × 2 mm) were separated into 8 groups (n = 8): S + TB: PHS (spray) + tooth brushing; TB + S: tooth brushing + PHS (spray); I + TB: PHS (immersion) + tooth brushing; TB + I: tooth brushing + PHS (immersion); TB: tooth brushing; S: PHS spray; I: immersion in PHS solution, and Saliva: immersion in saliva. Tooth brushing simulation (Mavtec, Brazil) was performed (356 rpm on 3.8 cm area by the toothbrush - Soft Tek) for 1, 7, 15, and 30 days. PHS remained in contact with specimens for 15 min. The specimens were evaluated before and after tooth brushing for color alteration (Easy Shade, VITA), and surface roughness (Model SJ-201P Mitutoyo), and Knoop microhardness (HMV-2, Shimadzu Corporation). For the in situ analyses, 8 participants were recruited and received an intraoral device with 6 fragments of bovine enamel (6 × 6 × 2 mm). The properties evaluated were the same as those of the in vitro study. Participants were randomized following best results of in vitro tested protocols, for 15 days: TB, TB + S, I + TB. Data obtained by in vitro (two-way ANOVA, Tukey, p < .05) and in situ (one-way ANOVA, Tukey, p < .05) studies were analyzed. RESULTS: The in vitro study showed that greater color change was found after 30 days. The greatest differences in surface roughness occurred between the initial value and after 1 day. Regarding microhardness, the highest values occurred after 15 and 30 days, which showed similar results. The in situ study showed greater color changes for the TB and I + TB, and greater surface roughness changes for TB as well as a similar increase in microhardness for the PHS protocols, which were higher than TB. CONCLUSIONS: Phytosphingosine leads to an increase in performance regarding color stability, surface roughness, and microhardness when applied. In general, the application of PHS after brushing showed a positive impact on its performance. CLINICAL RELEVANCE: Phytosphingosine proved to be interesting for compound prevention formulations in the dentistry field.

Relación de la condición bucal y el desarrollo psicomotor en niños de 6 y 7 años / Relationship between oral condition and psychomotor development in children aged 6 and 7 years

Introducción: La salud oral es un problema actual en la sociedad, las medidas preventivas como técnicas de cepillado deben de ser acorde a la destreza motriz. Objetivo: Evaluar la relación entre las condiciones bucales y el desarrollo psicomotor en los niños de 6 y 7 años. Métodos: La muestra estuvo conformada por 30 niños en el rango de edad de 6 y 7 años, que acuden al colegio "Manuel Bonilla" (Lima, Perú). Estuvo dividida por 2 grupos, a los cuales se les enseñó dos técnicas de cepillado: técnica de Bass modificada y técnica de Fones. Se obtuvieron valores de condiciones bucales, según los niveles de índice gingival, índice de higiene y el nivel de severidad. Por otro lado, se adquirieron los niveles de psicomotricidad, evaluados mediante el test de Bruininks-Oseretsky. El análisis de los datos estadísticos se ejecutó con el programa SPSS y R. Resultados: Un grupo de 29 niños se incorporaron en la muestra y fueron analizados un total de 631 dientes. Los resultados demostraron una asociación positiva con un solo rango (índice de sangrado gingival) de condiciones bucales y aspectos psicomotores de niños entre 6 y 7 años. Adicionalmente, se encontró una asociación positiva entre la técnica de cepillado Bass Modifica y condiciones bucales óptimas. Conclusiones: Los resultados actuales sugieren una asociación marginal entre las variables estudiadas, que puede ser potencialmente más significativa con una ampliación sobre el número de muestra. A medida que el ser humano va desarrollando nuevas habilidades motoras, debería de tener un mejor dominio sobre las necesidades básicas de salud como la ponderación de una buena higiene bucal. Por lo tanto, es necesario recomendar técnicas de cepillado de acuerdo al nivel de desarrollo psicomotor del niño(AU)

Introduction: Oral health is a current problem in society; preventive measures such as brushing techniques must be according to motor skills. Objective: Evaluate the relationship between oral conditions and psychomotor development in children aged 6 and 7 years. Methods: The sample consisted of 30 children in the age range of 6 and 7 years, who attend "Manuel Bonilla" school (Lima, Peru). It was divided by 2 groups, which were taught two brushing techniques: Bass-modified technique and Fones technique. There were obtained values of oral conditions, according to the levels of gingival index, hygiene index and the level of severity. On the other hand, the levels of psychomotricity were acquired, evaluated by the Bruininks-Oseretsky test. The analysis of the statistical data was executed with the SPSS and R program. Results: A group of 29 children were incorporated into the sample and a total of 631 teeth were analyzed. The results demonstrated a positive association with a single range (gingival bleeding index) of oral conditions and psychomotor aspects of children between 6 and 7 years. Additionally, a positive association was found between the Bass Modifica brushing technique and optimal oral conditions. Conclusions: The current results suggest a marginal association between the variables studied, which may be potentially more significant with an increase in the sample number. As humans develop new motor skills, they should have a better command of basic health needs such as weighing good oral hygiene. Therefore, it is necessary to recommend brushing techniques according to the level of psychomotor development of the child(AU)

Agentes e métodos de descontaminação das escovas dentais - Uma revisão sistemática / Decontamination agents and methods of toothbrushes - A systematic review

Objetivo: Realizar uma revisão sistemática para avaliar os principais agentes e métodos de descontaminação das escovas dentais contra vírus, bactérias e fungos encontrados na literatura. Métodos: Foi realizada uma busca nas bases de dados LILACS® (Literatura científica e técnica da América Latina e Caribe/BVS ­ Biblioteca Virtual em Saúde), MEDLINE® (Medical Literature Analysis and Retrieval System Online / PubMed)®, EMBASE® (Elsevier), em agosto de 2020. Como critério de inclusão, foram selecionados artigos publicados entre os anos de 2010 e 2020, nos idiomas português, inglês e espanhol, estudos de ensaios clínicos controlados randomizados, ensaios clínicos não randomizados e estudos in vitro, que avaliaram diferentes agentes e métodos de descontaminação das escovas dentais. Resultados: Foram recuperados um total de 2523 artigos, sendo qualificados para o estudo um total de 6 artigos "in vivo" e 4 "in vitro". O agente de descontaminação mais estudado e eficaz foi a clorexidina 0,12% (em forma de imersão ou spray), seguida pelo hipoclorito de sódio 1% e 2,5% (imersão), vinagre branco 50% (imersão), solução de cloreto de cetilpiridínio (imersão ou spray), micro-ondas e máquina de lavar-louças. Conclusão: Considerando as evidências de qualidade encontradas, a clorexidina 0,12% constitui o agente mais estudado e eficaz, seguido pelo hipoclorito de sódio 1 % e cloreto de cetilpiridínio, utilizados em forma de spray ou imersão, constituem soluções eficazes, de fácil acesso, que podem ser utilizadas pela população para descontaminação das escovas dentais.

Aim: To carry out a systematic review of articles found in the literature in order to evaluate the main agents and methods for decontaminating toothbrushes against viruses, bacteria, and fungi. Methods: A search was performed in LILACS® (Scientific and Technical Literature of Latin America and the Caribbean/VHL ­ Virtual Health Library), MEDLINE® (Medical Literature Analysis and Retrieval System Online /PubMed)®, and EMBASE® databases (Elsevier), in August 2020. As inclusion criteria, articles published between 2010 and 2020, in Portuguese, English, and Spanish, studies of randomized controlled clinical trials, non-randomized clinical trials, and in vitro studies were selected, which evaluated different agents and methods for decontaminating toothbrushes. Results: A total of 2,523 articles were retrieved, with a total of 6 in vivo and 4 in vitro articles deemed to be eligible for the study. The most studied and effective decontamination agent was 0.12% chlorhexidine (in immersion or spray form), followed by 1% and 2.5% sodium hypochlorite (immersion), 50% white vinegar (immersion), solution of cetylpyridinium chloride (dip or spray), microwave, and dishwasher. Conclusion: Considering the quality evidence found, 0.12% chlorhexidine is the most studied and effective agent, followed by 1% sodium hypochlorite and cetylpyridinium chloride, used in spray or immersion form; these are effective, easily accessible solutions that can be used by the population to decontaminate toothbrushes.

La higiene bucal en pacientes con tratamiento de Ortodoncia / Oral hygiene in patients with orthodontic treatment

RESUMEN Fundamento: Los pacientes con tratamiento de ortodoncia presentan alteraciones por la acumulación de placa que provoca los aparatos, lo que requiere de mayor control de la higiene bucal. Objetivo: Profundizar en los criterios actuales sobre la higiene bucal en pacientes con tratamiento de ortodoncia para mantener su salud bucal. Desarrollo: Se realizó una búsqueda bibliográfica en las bases de datos biomédicas: PubMed, Cochrane, Scopus, Ebsco, Cumed y Lilacs. De 86 artículos científicos se seleccionaron los 39 de mayor actualización. Se constataron las particularidades de la higiene bucal durante el tratamiento con aparatos fijos de ortodoncia, la existencia del Índice de placa de ortodoncia como índice ajustado para estos pacientes, los procedimientos para el control de la placa bacteriana, la relación entre el uso de aparatos y el pH salival, así como la importancia de la educación para la salud para aumentar la motivación de los pacientes hacia la higiene bucal. Conclusiones: La higiene bucal es el factor más importante en el mantenimiento de la salud periodontal y la prevención de caries dental durante el tratamiento de ortodoncia. Se requiere de la orientación por parte de los profesionales para motivar a los pacientes mediante la promoción y prevención de salud bucal.

ABSTRACT Background: Patients with orthodontic treatment present alterations due to the plaque addition caused by the appliances, which requires greater control of oral hygiene. Objective: To delve into the current criteria on oral hygiene in patients with orthodontic treatment to maintain their oral health. Development: A bibliographic search was conducted in biomedical databases: PubMed, Cochrane, Scopus, Ebsco, Cumed and Lilacs. Out of 86 scientific articles, the 39 most updated were selected. The accuracies of oral hygiene during the treatment with fixed orthodontic appliances, the existence of the Orthodontic Plaque Index as an adjusted index for these patients, the procedures for bacterial plaque control, the relationship between the use of appliances and salivary pH, as well as the importance of health education to increase patients' motivation towards oral hygiene were ascertained. Conclusions: Oral hygiene is the most important factor to preserve periodontal health and prevent dental caries during orthodontic treatment. Guidance by professionals is required to motivate patients through oral health promotion and prevention.

The effectiveness of apple, sugar-free chewing gum, Rolly Brush® and tooth brushing in the reduction of plaque index: Crossover randomized clinical trial

Background: The implementation of the self-cleaning practice is of fundamental importance for the maintenance of oral health and to remove the human dental biofilm which is considered the main etiological factor for the development of caries and periodontal diseases. Objective: This study aimed to evaluate the use of chewing gum, Rolly Brush® and apples as forms of mechanical control and removal of the dental biofilm in the absence of brushing. Materials and Methods: Eighteen volunteers were submitted to plaque index evaluation after a period of 24 hours of no oral hygiene. Then, they would use one of the methods: chewing gum, Rolly Brush®, apple or tooth brushing, chosen by a draw, for one minute, and then, plaque index was evaluated again. This stage was repeated until all participants were submitted to all selected methods, in periods of 24 hours each. Results: Dental brushing was more effective when compared to each of the other methods applied and there was a statistically significant reduction of dental plaque index after apllying all methods of cleaning in all groups. Conclusion: Chewing gum, Rolly Brush® and apple may be used as auxiliary to dental brushing or when such method is impossible to be performed. Clinicaltrials.gov: number of protocol NCT 03.601.585.

Fundamento: A implementação da prática de autolimpeza é de fundamental importância para a manutenção da saúde bucal e remoção do biofilme dental humano que é considerado o principal fator etiológico para o desenvolvimento de cáries e doenças periodontais. Objetivo: Este estudo teve como objetivo avaliar a utilização de goma de mascar, Rolly Brush® e maçã como formas de controle mecânico e remoção do biofilme dental na ausência de escovação. Materiais e Métodos: Dezoito voluntários foram submetidos à avaliação do índice de placa após um período de 24 horas sem higiene bucal. Em seguida, utilizariam um dos métodos: goma de mascar, Rolly Brush®, ingerir uma maçã e escovar os dentes, escolhida por sorteio, por um minuto, e então, o índice de placa era novamente avaliado. Essa etapa foi repetida até que todos os participantes fossem submetidos a todos os métodos selecionados, em períodos de 24 horas cada. Resultados: A escovação dentária foi mais eficaz quando comparada a cada um dos outros métodos aplicados e houve redução estatisticamente significativa do índice de placa dentária após a aplicação do método de limpeza em todos os grupos. Conclusão: Goma de mascar, Rolly Brush® e maçã podem ser utilizados como auxiliares da escovação dentária ou quando tal método for impossível de ser realizado. Clinicaltrials.gov: Número do protocolo NCT 03.601.585.

La higiene oral y los efectos de la terapia periodontal mecánica / Oral hygiene and effects of mechanical periodontal therapy

Introducción: Las enfermedades periodontales junto con la caries dental son las patologías más frecuentes que afectan los dientes y tejidos circundantes. El principal agente etiológico es el acúmulo de biopelícula dental bacteriana ya sea en las fosas y fisuras de los dientes como en el surco gingival. Objetivo: La presente revisión narrativa tuvo por objetivo sintetizar los resultados de la terapia mecánica sobre la higiene oral al ser indicadas en pacientes con diagnóstico de periodontitis. Material y Métodos: Se realizó un estudio descriptivo que se basó en una revisión crítica de las publicaciones relacionadas a la terapia periodontal mecánica en las bases de datos: Scopus, SciELO (Scientific Electronic Library Online), MEDLINE (Pubmed), ScienceDirect así como el buscador Google académico. En cada base de datos se realizó una búsqueda libre de la información con un límite de 10 años de antigüedad de las fuentes de información para analizar tanto fuentes antiguas como actuales. Resultados: De una búsqueda inicial de 678 artículos se incluyeron 52 estudios que compararon técnicas de higiene oral, así como revisiones sistemáticas que sintetizaron el efecto de la terapia mecánica periodontal. Conclusiones: El tratamiento periodontal debe ser considerado la terapia inicial para la periodontitis, debe incluir instrucción en técnicas de higiene para el control de la biopelícula dental y el debridamiento mecánico de las zonas afectadas. No se ha demostrado que una técnica de cepillado manual específica sea superior a otras, por tanto, se debería aplicar aquella que mejor pueda manejar el paciente. No se encontró evidencia que demuestre que el uso del hilo dental disminuya eficientemente los índices de biopelícula dental y parámetros gingivales debido a la dificultad por parte del paciente para emplear adecuadamente la técnica(AU)

Introduction: Periodontal diseases together with dental caries are the most frequent pathologies affecting the teeth and surrounding tissues. The main etiological agent is the accumulation of bacterial dental biofilm in the pits and fissures of the teeth and the gingival sulcus. Objective: The present narrative review aimed to synthesize the results of mechanical therapy on oral hygiene when it is indicated in patients with the diagnosis of periodontitis. Material and methods: A descriptive study was conducted. It was based on a critical review of some articles related to mechanical periodontal therapy published in databases such as Scopus, SciELO (Scientific Electronic Library Online), PubMed/ MEDLINE and ScienceDirect. Google search engine was also used. A free search for information was carried out in each database. An age limit of 10 years was established for the analysis of both old and current sources. Results: The initial search included 678 articles. Of these, 52 studies that compared oral hygiene techniques as well as systematic reviews that synthesized the effect of mechanical periodontal therapy were included. Conclusions: Periodontal treatment should be considered as the initial therapy for the treatment of periodontitis. It should include oral hygiene instructions for the control of dental biofilm and mechanical debridement of the affected areas. A specific manual brushing technique has not been proven to bebetter than others; therefore, the one that can best be performed by the patient should be used. There was no proven evidence that effective flossing reduces dental biofilm indexes and gingival parameters due to the patient difficulty to adequately perform the technique(AU)

Combination of toothbrushing and chlorhexidine compared with exclusive use of chlorhexidine to reduce the risk of ventilator-associated pneumonia: A systematic review with meta-analysis

This study aimed to compare the effectiveness of 0.12% chlorhexidine alone and 0.12% chlorhexidine in combination with toothbrushing to prevent ventilator-associated pneumonia (VAP) in mechanically ventilated patients. The Embase, Latin American and Caribbean Health Science Literature, PubMed, Scientific Electronic Library Online, Scopus, LIVIVO, Web of Science, Cochrane Library, OpenThesis, and Open Access Thesis and Dissertations databases were used. Only randomized controlled trials without restrictions on the year or language of publication were included. Two reviewers assessed the risk of bias using the Joanna Briggs Institute Critical Appraisal Tool. A meta-analysis using a random-effects model estimated the combined relative risk (RR). The Grading of Recommendations, Assessment, Development and Evaluations approach was used to assess the certainty of the evidence. Initially, 2,337 studies were identified, of which 4 were considered in the systematic review and 3 in the meta-analysis (total sample: 796 patients). The studies were published between 2009 and 2017. All eligible studies had a low risk of bias. The meta-analysis revealed that the risk of VAP was 24% lower in patients receiving chlorhexidine combined with toothbrushing than in those receiving chlorhexidine alone (RR: 0.76; 95% confidence interval: 0.55-1.06), with moderate certainty of evidence and without statistical significance. In conclusion, considering the limitations of this study, a standard protocol for the prevention of VAP is not yet recommended. More studies with larger sample sizes are needed to draw strong conclusions. However, considering that toothbrushing is a simple intervention, it should be a common practice in mechanically ventilated patients, especially among patients with coronavirus disease.

Conceptualization of dental caries by dental students is related to their preventive oral care routine.

OBJECTIVE: Whether the understanding of dental caries influences how future dentists manage the disease themselves has not been previously studied. Thus, this study evaluated whether the conceptualization (understanding) of dental caries by dental students is related to their own preventive oral care routine. METHODS: Dental students at a U.S. dental school (n = 517) were invited to voluntarily respond to an anonymous electronic survey in spring 2018. Demographic characteristics, caries conceptualization (CC), dental care habits, and self-caries risk determination were asked. Discursive responses to CC were analyzed by content analysis technique, and categories [c] were created. Chi-square and Fisher's exact tests were used for analysis. RESULTS: Overall response rate was 54.5% (n = 282, 48.2% female). Three researchers independently analyzed discursive answers and classified them into 1 of 6 caries concept categories [c]: [c1] only signs of the disease (10.3%), [c2] bacterial disease-not specifying bacterial metabolism (38.3%), [c3] bacterial byproducts-not specifying substrate (13.8%), [c4] biological or multifactorial concept (24.8%), [c5] comprehensive multifactorial disease (8.2%), or [c6] other (4.6%). Only 33% completely defined dental caries according to the modern understanding of the disease (c4-c5). Statistical differences were found between: CC and diet modification, CC and rinsing after brushing, year of school (YS) and self-determined caries-risk, YS and brushing at school, and YS and rinsing after brushing (P < 0.05). CONCLUSION: Our data suggest that the students' understanding of the disease can influence how they will manage the disease in terms of diet modification and behavior after brushing. Moreover, self-caries risk determination influenced students' brushing behavior.

Tooth-brushing epilepsy: an SEEG study and surgical treatment.

We report a patient with reflex tooth-brushing-triggered epilepsy, associated with a post-central lesion within the right somatosensory face area. Contralateral facial sensory and motor phenomena, associated with contralateral upper limb extension, were present at seizure onset after gingival stimulation, but seizures could also be induced by contact with solid food or liquids. Spontaneous seizures also were recorded. Secondary generalization was infrequent. Stereoelectroencephalography implantation was performed, with seizure recording and cortical/subcortical stimulation for mapping, to identify the precise extent of surgical resection. Complete postoperative control of epilepsy was achieved, accompanied by a mild and transient neurological deficit. [Published with video sequence].

Assessment of the efficacy of the utilisation of conventional and electric toothbrushes by the older adults.

OBJECTIVE: To evaluate the efficacy of electric and conventional toothbrushes for a group of elderly individuals. BACKGROUND: Although the electric toothbrush has been recommended for elderly individuals, there had previously never been a study regarding its efficacy. MATERIAL AND METHODS: Sixty independent elders of both genders with different oral conditions from the Center Adult Day Vitória, Espírito Santo, Brazil, were randomly divided into two groups of 30 individuals. One group received the Oral B CrossAction Power electric toothbrush, whereas the other received a conventional Bitufo Class 32 soft toothbrush to perform oral hygiene. The bacterial plaque index (O'Leary Plaque Index) and DMFT index were assessed as a measure of oral hygiene and oral health. The data were analysed using the Shapiro-Wilk, Mann-Whitney and Wilcoxon tests. RESULTS: The results of the efficacy of the Oral B Cross Action Power electric toothbrush demonstrated that on the 7th and 15th days, the bacterial plaque indexes were 24.91 ± 12.81 and 22.11 ± 14.46, respectively, which corresponds to a 50.24% removal of bacterial plaque on the 7th and 55.83% on the 15th days. Although the electric toothbrush removed more bacterial plaque than the conventional toothbrush, the difference was not statistically significant. CONCLUSION: Both the conventional and the electric toothbrushes were effective in removing bacterial plaque within the elderly group. More studies are necessary to test the efficacy of electric toothbrushes in relation to conventional toothbrushes for elderly patients.

Factors affecting the color stability and staining of esthetic restorations.

This study aimed to assess the color stability of two composite resins, unprotected or protected with a hydrosoluble gel (oxygen inhibitor) during final polymerization, when subjected to different staining solutions and daily tooth brushing simulation. Nanohybrid composite (IPS Empress Direct) or nanofilled composite (Filtek Z350) were used to produce round samples that were either unprotected or protected with a hydrosoluble gel before the final cycle of polymerization. For 5 days, the samples were immersed for 1 h/day in four different staining solutions: distilled water (control), coffee, soft drink, and red wine. Once a day, the samples were also subjected to mechanical brushing with soft-bristled brushes for 30 min. The combination of experimental conditions produced 16 groups (n = 10). Color changes (ΔE) were evaluated at baseline and after mechanical brushing cycles for 1, 3, and 5 days. Data were analyzed by linear regression models. Protection with hydrosoluble gel was able to significantly reduce the color change only on the first day (p = 0.001). The type of composite resin did not significantly affect the color change over the days. Wine affected composite resin color change only on the first day (p = 0.002). Over time, color stability of composite resins did not improve with the protection of a hydrosoluble gel before the final polymerization.

Periodontal profile and oral hygiene status in pregnants at maternity hospital in the state of Goias, Brazil

ABSTRACT: Objective: The aim of this study was to assess the periodontal status of women during pregnancy attended in a maternity hospital, as well as their oral hygiene habits. Materials and Methods: The sample was composed by 100 pregnant women, ranging from their first to ninth month of pregnancy, were examined at a maternity hospital in Goiás, Brazil. They received information about oral hygiene techniques and they were submmited a periodontal examination in a dentist's office, where the Periodontal Screening and Recording (PSR) codes were verified along with bleeding on probing and tooth loss. Results: About their pregnancy period, the most (46%) were in their third trimester at the time of this study. The gingival index showed an average of 12% and 90% of the patients presented PSR Code 2. As for dental hygiene, 55% reported brushing three times a day and 48% used dental floss daily. Conclusion: The most pregnant women in the third trimester, showed a prevalence for gingivitis. They reported brushing their teeth three times a day and using dental floss daily.

[72-month evaluation of an oral health prevention strategy in schoolchildren]. / Evaluación a 72 meses de una estrategia de prevención en salud oral en escolares.

OBJECTIVE: Given the high prevalence of caries and periodontal disease globally, and its cumulative process from an early age, effective strategies are required to influence healthy habits that are formed in a sustainable manner, taking advantage of common spaces such as school. The objective was to evaluate for 72 months an oral health prevention strategy in schoolchildren. METHODS: This quasi-experimental study considered an initial sample of 350 students with similar cultural and socioeconomic conditions, which was later reduced to 220, after the 72 months. The tooth brushing practice was carried out at school daily; with teacher motivation and leader in oral health formation. Intervention was supervised all time long. to At the beginning and end of the 72 months, the following epidemiological indexes were taken: Silness-Loe plaque index, Loe-Silness Gingival index, brushing skill index by Simmons Smith & Gelbie (ISSG), and the MEDI-MED index that dichotomically considered: healthy permanent teeth, health of the gums and good attitude towards dental health. The statistical analysis included measures of central tendencies. The difference in averages of the indices was determined by the Mann-Whitney U test. RESULTS: The average of the indices: initial (II) and final (IF) registered as follows: gingival (II: 0.63-IF: 0.27) and bacterial plaque (II: 0.99-IF: 0.41) with a difference p <0.05. The index (ISSG) indicated a dental plaque removal of 82.18%.MEDI-MED index "healthy permanent teeth" (II: 91% - IF: 59%); Gum (II: 14% - IF: at 85%) and the "Mind" component (II: 96% - IF: 87%). CONCLUSIONS: The preventive strategy evaluated significantly reduced the rates of bacterial and gingival plaque. The MEDI-MED index indicated decreased in healthy permanent teeth and a positive attitude towards dentistry.

OBJETIVO: Dada la alta prevalencia de caries y enfermedad periodontal a nivel global, y su proceso acumulativo desde temprana edad, se requieren estrategias efectivas para incidir en hábitos saludables que se formen de manera sostenible, aprovechando espacios comunes como la escuela. El objetivo de este estudio fue evaluar a 72 meses una estrategia de prevención en salud oral en escolares. METODOS: Esta investigación cuasi-experimental, longitudinal consideró una muestra inicial de 350 escolares con condiciones culturales y socioeconómicas similares, que después de 72 meses se redujo a 220. La práctica de cepillado dentro de la escuela se realizó diariamente, con motivación de sus maestros y formación de lideres de salud oral. Durante todo el tiempo la intervención estuvo supervisada. Al inicio y a los 72 meses, se tomaron los índices epidemiológicos: de Placa de Silness y Loe, Gingival de Loe y Silness, cepillado de Simmons Smith y Gelbie (ICSG), y el índice MEDIMED que consideró dicotómicamente: dientes permanentes sanos, salud de la encía y buena actitud hacia la odontología. El análisis estadístico incluyó medidas de tendencia central. La diferencia de promedios de los índices se determinó con la prueba U de Mann Whitney. RESULTADOS: Los promedios de los índices iniciales (II) y finales (IF) registraron así: gingival (II: 0,63-IF: 0,27) y placa bacteriana (II: 0,99-IF: 0,41) con una diferencia p <0,05. El índice (ICSG) indicó una remoción de placa dental del 82,18%. El índice MEDIMED: "dientes permanentes sanos" (II: 91% - IF: 59%); encía (II: 14% - IF: a 85%) y el componente "Mente" (II: 96 % - IF: 87%). CONCLUSIONES: La estrategia preventiva evaluada disminuyó los índices de placa bacteriana y gingival en forma significativa. El índice MEDIMED indicó disminucion en dientes permanentes sanos y disminución de una actitud positiva hacia la odontologia.

Correlation between plaque control and gingival health using short and extended oral hygiene intervals.

OBJECTIVES: To evaluate the correlation between dental plaque formation and gingival health in subjects performing high oral hygiene standards over short or extended intervals. MATERIALS AND METHODS: Fifty-two non-dental students volunteered for this study. The subjects, trained to perform high oral hygiene standards, were randomized to perform oral hygiene at 12-, 24-, 48-, or 72-h interval over 30 days. The plaque index (PlI) and the gingival index (GI) were evaluated at baseline, 15, and 30 days. For the statistical analysis, oral hygiene intervals were collapsed into daily (12 and 24 h; G12/24) and extended (48 and 72 h; G48/72) intervals. Summary statistics (mean ± SD) and Spearman correlations between the PlI and the GI at baseline, 15, and 30 days were estimated. RESULTS: At baseline, correlation coefficients between PlI and GI were positive for both groups (r = 0.29 and r = 0.25). At day 15 and 30, correlation was maintained with similar baseline values for the G48/72 group. GI levels did not increase despite an increase in PlI for the G12/24 group, and the correlation was lower than that observed at baseline (r = 0.13 vs. r = 0.29). CONCLUSIONS: In subjects with high oral hygiene standards, the oral hygiene frequency governs the correlation between dental plaque formation and gingival health. Subjects performing high oral hygiene standards at daily intervals will maintain gingival health in difference to subjects using extended hygiene intervals. CLINICAL RELEVANCE: Subjects performing high oral hygiene standards at daily intervals will maintain gingival health in difference to subjects using extended hygiene intervals.

Effect of saliva collection methods and oral hygiene on salivary biomarkers.

The aim of this study was to evaluate the influence of unstimulated and stimulated saliva collection methods, as well as tooth brushing, on the secretion rate of salivary total protein, nitrite, total antioxidant capacity and alpha-amylase. Saliva of 14 healthy individuals were collected with stimulation using Salivette®, Parafilm® and chewing gum and without stimulation from spit with and without fluid accumulation, before and after oral hygiene. Total protein, nitrite, total antioxidant capacity and alpha-amylase concentration (sAA) were evaluated. The collection of saliva stimulated with Parafilm® and chewing gum increased the salivary flow (1.5 ± 0.4 and 3.4 ± 0.7 mL/min, respectively) and the secretion rate of salivary total protein (1.0 ± 0.2 and 2.3 ± 0.5 mg/min, respectively). Also, chewing gum increases the salivary nitrite secretion (213 ± 58 nmol/min) and total antioxidant capacity (410 ± 47 nmol trolox eq/min). Interestingly, the unstimulated method without saliva accumulation prior to collection resulted in low sAA levels (23,531 ± 7979 pixel density). Furthermore, oral hygiene decreased salivary flow (1.3 ± 0.5 to 1.0 ± 0.4 mL/min), reduced the secretion rate of total protein (1.0 ± 0.5 to 0.6 ± 0.2 mg/min, p < .05) and increased sAA (13,159 ± 7114 to 20,075 ± 25,656 pixel density, p < .05). The type of stimulation can activate autonomous receptors responsible for the secretion and composition of saliva. Therefore, the evaluation of saliva collection methods and oral hygiene on salivary biomarkers is important for understanding and standardizing variations in salivary composition to strengthen the use of saliva as a diagnostic fluid.

Effect of a School-Based Supervised Tooth Brushing Program In Mexico City: A Cluster Randomized Intervention.

Large-scale school-based programs effectively provide health education and preventive strategies. SaludARTE is a school-based program, including supervised tooth brushing, implemented in 51 elementary schools in Mexico City. OBJECTIVES: To assess the three-month efficacy of supervised tooth brushing in reducing dental plaque, gingival inflammation, and bleeding on probing in schoolchildren participating in SaludARTE. STUDY DESIGN: This was a pragmatic cluster randomized intervention, with two parallel branches. Four randomly selected schools participating in SaludARTE (n=200) and one control school, which did not participate in the program (CG) (n=50), were assessed. Clusters were not randomly allocated to intervention. The main outcomes were as follows: mean percentage gingival units with no inflammation, dental surfaces with no dental plaque, and gingival margins with no bleeding. The independent variable was supervised tooth brushing at school once a day after a meal. Guardians and children responded to a questionnaire on sociodemographic and oral hygiene practices, and children were examined dentally. Mean percentage differences were compared (baseline and follow-up). RESULTS: A total of 75% of guardians from the intervention group (IG) and 77% from the CG answered the questionnaire. Of these, 89.3% were women, with a mean age of 36.9±8.5 years. No differences in sociodemographic variables were observed between groups, and 151 children from the IG and 35 from the CG were examined at baseline and follow-up. Mean percentage differences for plaque-free surfaces (8.8±28.5%) and healthy gingival units (23.3%±23.2%) were significantly higher in the IG. CONCLUSION: The school-supervised tooth brushing program is effective in improving oral hygiene and had a greater impact on plaque and gingivitis than on gingival bleeding. It is necessary to reinforce the oral health education component of the program.

Porphyromonas gingivalis na cavidade oral de neonatos da raça Bulldog Inglês / Porphyromonas gingivalis in the oral cavity of English bulldog newborn puppies

Background: Periodontal disease (PD) is the most common disease of the oral cavity in cats and dogs, and it affects up to 80% of these animals. PD begins with the accumulation of bacteria on the surface of the teeth, and it poses a risk for the health of pets. Research on PD in dogs has focused on the identification and characterization of bacterial communities present in the oral cavity. Porphyromonas gingivalis is highly prevalent in the oral cavity. Therefore, the aim of this study was to detect P. gingivalis before and after dental eruption in 15 English bulldog newborn puppies, hoping to contribute to early guidance of oral hygiene management and prevent future PD. Materials, Methods & Results: Fifteen English bulldog newborn puppies were used in this study. Two groups (G1 and G2) were formed with eight and seven puppies, respectively. Oral swab samples were taken from the maxillary incisor region of animals from G1 and G2 10 days after birth (T10). At this moment, the clinical evaluation of the oral cavity showed healthy gums with a thin, shiny, pinkish, and firm margin, without any odor or granular appearance, and with no tooth eruption. On postnatal day 25 (T25), a subgingival sample was collected with a Gracey curette from the maxillary incisors; the oral cavity examination revealed healthy gums and presence of gingival sulcus. Bilateral subgingival samples were also collected from the maxillary canines and fourth premolars of the dams at T10 and T25. All newborn puppies were fed maternal breast milk and supplementation exclusively with commercial milk for dogs in individual bottles. The dams were fed commercial dry food. The average weight of G1 and G2 at T10 was 625.87 ± 85.26 g and 543.50 ± 92.88 g, respectively, and 100% (15/15) of the animals were negative for PG as assessed by polymerase chain reaction (PCR) on oral swab samples. [...](AU)

Porphyromonas gingivalis in the Oral Cavity of English Bulldog Newborn Puppies

Background: Periodontal disease (PD) is the most common disease of the oral cavity in cats and dogs, and it affects up to 80% of these animals. PD begins with the accumulation of bacteria on the surface of the teeth, and it poses a risk for the health of pets. Research on PD in dogs has focused on the identification and characterization of bacterial communities present in the oral cavity. Porphyromonas gingivalis is highly prevalent in the oral cavity. Therefore, the aim of this study was to detect P. gingivalis before and after dental eruption in 15 English bulldog newborn puppies, hoping to contribute to early guidance of oral hygiene management and prevent future PD.Materials, Methods & Results: Fifteen English bulldog newborn puppies were used in this study. Two groups (G1 and G2) were formed with eight and seven puppies, respectively. Oral swab samples were taken from the maxillary incisor region of animals from G1 and G2 10 days after birth (T10). At this moment, the clinical evaluation of the oral cavity showed healthy gums with a thin, shiny, pinkish, and firm margin, without any odor or granular appearance, and with no tooth eruption. On postnatal day 25 (T25), a subgingival sample was collected with a Gracey curette from the maxillary incisors; the oral cavity examination revealed healthy gums and presence of gingival sulcus. Bilateral subgingival samples were als

Porphyromonas gingivalis na cavidade oral de neonatos da raça Bulldog Inglês / Porphyromonas gingivalis in the oral cavity of English bulldog newborn puppies

Background: Periodontal disease (PD) is the most common disease of the oral cavity in cats and dogs, and it affects up to 80% of these animals. PD begins with the accumulation of bacteria on the surface of the teeth, and it poses a risk for the health of pets. Research on PD in dogs has focused on the identification and characterization of bacterial communities present in the oral cavity. Porphyromonas gingivalis is highly prevalent in the oral cavity. Therefore, the aim of this study was to detect P. gingivalis before and after dental eruption in 15 English bulldog newborn puppies, hoping to contribute to early guidance of oral hygiene management and prevent future PD. Materials, Methods & Results: Fifteen English bulldog newborn puppies were used in this study. Two groups (G1 and G2) were formed with eight and seven puppies, respectively. Oral swab samples were taken from the maxillary incisor region of animals from G1 and G2 10 days after birth (T10). At this moment, the clinical evaluation of the oral cavity showed healthy gums with a thin, shiny, pinkish, and firm margin, without any odor or granular appearance, and with no tooth eruption. On postnatal day 25 (T25), a subgingival sample was collected with a Gracey curette from the maxillary incisors; the oral cavity examination revealed healthy gums and presence of gingival sulcus. Bilateral subgingival samples were also collected from the maxillary canines and fourth premolars of the dams at T10 and T25. All newborn puppies were fed maternal breast milk and supplementation exclusively with commercial milk for dogs in individual bottles. The dams were fed commercial dry food. The average weight of G1 and G2 at T10 was 625.87 ± 85.26 g and 543.50 ± 92.88 g, respectively, and 100% (15/15) of the animals were negative for PG as assessed by polymerase chain reaction (PCR) on oral swab samples. [...]