EFFECT OF AN ORAL HEALTH PROMOTION PROGRAM ON GASTROPLASTY PATIENTS: A RANDOMIZED CLINICAL TRIAL.

BACKGROUND: Bariatric surgery can cause oral health problems in individuals, such as an increase in dental caries, periodontal diseases and dental erosion, which can be avoided if oral health promotion actions are implemented. AIMS: To assess the impact of an oral health promotion program implemented among gastroplasty patients. METHODS: This randomized clinical trial involved 208 patients undergoing gastroplasty; they were divided into two groups: Intervention Group, with participation in the Oral Health Promotion Program for Bariatric Patients, or Control Group. Assessments were carried out preoperatively, and six and 12 months postoperatively. The oral conditions assessed were: dental caries, periodontal diseases, tooth wear, dental plaque, and salivary flow. Sociodemographic information was obtained through application of structured questionnaires. For data analysis, the Chi-Square, Fisher's Exact, and Mann-Whitney tests were performed - α=5%. RESULTS: Patients in the Intervention Group, when compared to those in the Control Group, presented: fewer changes in enamel (6M: p<0.0001; 12M: p=0.001), in dentin (6M: p<0.0001; 12M: p<0.0001), moderate tooth wear (6M=0.002; 12M=0.005), gingival bleeding (6M: p<0.0001), dental calculus (6M=0.002; 12M: p=0.03), periodontal pocket 4-5 mm (6M=0.001; 12M: p=<0.0001); greater reduction in the bacterial plaque index (6M: p<0.0001; 12M: p<0.0001), and increased salivary flow (6M: p=0.019). CONCLUSIONS: The oral health promotion program had a positive impact on the prevention and control of the main problems to the oral health of the gastroplasty patients.

Effect of an oral health promotion program on gastroplasty patients: a randomized clinical trial / Efeito de um programa de promoção de saúde bucal em gastroplastizados: ensaio clínico randomizado

ABSTRACT BACKGROUND: Bariatric surgery can cause oral health problems in individuals, such as an increase in dental caries, periodontal diseases and dental erosion, which can be avoided if oral health promotion actions are implemented. AIMS: To assess the impact of an oral health promotion program implemented among gastroplasty patients. METHODS: This randomized clinical trial involved 208 patients undergoing gastroplasty; they were divided into two groups: Intervention Group, with participation in the Oral Health Promotion Program for Bariatric Patients, or Control Group. Assessments were carried out preoperatively, and six and 12 months postoperatively. The oral conditions assessed were: dental caries, periodontal diseases, tooth wear, dental plaque, and salivary flow. Sociodemographic information was obtained through application of structured questionnaires. For data analysis, the Chi-Square, Fisher's Exact, and Mann-Whitney tests were performed — α=5%. RESULTS: Patients in the Intervention Group, when compared to those in the Control Group, presented: fewer changes in enamel (6M: p<0.0001; 12M: p=0.001), in dentin (6M: p<0.0001; 12M: p<0.0001), moderate tooth wear (6M=0.002; 12M=0.005), gingival bleeding (6M: p<0.0001), dental calculus (6M=0.002; 12M: p=0.03), periodontal pocket 4-5 mm (6M=0.001; 12M: p=<0.0001); greater reduction in the bacterial plaque index (6M: p<0.0001; 12M: p<0.0001), and increased salivary flow (6M: p=0.019). CONCLUSIONS: The oral health promotion program had a positive impact on the prevention and control of the main problems to the oral health of the gastroplasty patients.

RESUMO RACIONAL: A cirurgia bariátrica pode ocasionar agravos bucais no indivíduo, como o aumento de cárie dentária, doença periodontal e erosão dentária, que podem ser evitados se ações de promoção em saúde bucal forem implementadas. OBJETIVO: Avaliar o impacto de um programa de promoção de saúde bucal implementado junto a gastroplastizados. MÉTODOS: Este ensaio clínico randomizado envolveu 208 pacientes submetidos à gastroplastia, divididos em dois grupos: Grupo de Intervenção, com participação no Programa de Promoção de Saúde Bucal para Pacientes Bariátricos ou Grupo Controle. As avaliações foram feitas no pré-operatório e pós-operatório de 6 e 12 meses. As condições bucais avaliadas foram: cárie dentária, doença periodontal, desgaste dentário, placa dentária e fluxo salivar. Informações sociodemográficas foram obtidas pela aplicação de questionários estruturados. Para análise dos dados foram aplicados os testes Qui- Quadrado, Exato de Fisher e Mann-Whitney, α=5%. RESULTADOS: Pacientes do Grupo de Intervenção, quando comparados aos do Grupo Controle, apresentaram: menos alterações de esmalte (6M: p<0,0001; 12M: p=0,001), de dentina (6M: p<0,0001; 12M: p<0,0001), desgaste dentário moderado (6M=0,002; 12M=0,005), sangramento gengival (6M: p<0,0001), cálculo dentário (6M=0,002; 12M: p=0,03), bolsa periodontal de 4-5 mm (6M=0,001; 12M: p=<0,0001); maior redução no índice de placa bacteriana (6M: p<0,0001; 12M: p<0,0001) e aumento do fluxo salivar (6M: p=0,019). CONCLUSÕES: Houve impacto positivo do programa de promoção de saúde bucal na prevenção e controle dos principais agravos à saúde bucal dos gastroplastizados.

Intrauterine exposure to omeprazole increases the risk of teeth morphological anomalies in the offspring of a murine model.

Conditions experienced in early life have long-lasting effects on offspring health. Despite this, little is known about how maternal exposure to drugs during pregnancy affects offspring teeth morphogenesis. In humans, omeprazole is a common drug used to mitigate Gastroesophageal Reflux Disease. Importantly, omeprazole is a non-specific proton-pump inhibitor, which may inhibit the proton pumps expressed in the developing tooth germ. To date, however, the effects of intrauterine life exposure to omeprazole on offspring tooth development remain unknown. In this study, we addressed this gap in a murine model. Pregnant female Swiss mice were exposed to daily doses of 40 mg/kg of omeprazole from the 5th to the 17th day of pregnancy and the effects of such exposure on offspring odontogenesis parameters such as morphological abnormalities, disruptions in the ameloblast and odontoblast layers and the presence of dentin matrix were measured. Omeprazole exposure significantly increased the prevalence (control: 21.6%; treatment: 60%; p = 0.001) and the risk (posterior mean and 95% credible interval; control: 0.230 [0.129; 0.347]; treatment: 0.593 [0.449; 0.730]) of offspring teeth morphological abnormalities, although there were no statistically significant effects of omeprazole exposure on other parameters of tooth development. These findings suggest that there are potential side-effects to offspring oral health of omeprazole use during pregnancy.

Congenital anomalies and spontaneous abortion in mice resulting from the use of escitalopram.

CONTEXT: Escitalopram (ESC) use during pregnancy has not been associated with teratogenic effects in fetuses. AIMS: To investigate whether ESC administered during pregnancy in mice induces maternal toxicity and teratogenicity in offspring. METHODS: Treated mice groups G1 and control G0 (n =15 per group). Administration of ESC (G1) and saline solution (G0) during pregnancy and euthanasia on the 18thday. Pregnant female mice were treated with ESC (20mg/kg, via gavage) or saline solution (control group) from the 5th to the 17thday of gestation, when implantation was consolidated. During intraembryonic development until the day before delivery, the drug had an influence on the development of alterations from its maintenance in the uterine environment and its development to the disturbance causing skeletal or visceral malformations. KEY RESULTS: The intrauterine development parameters that were altered by ESC treatment were: number of resorptions (G0: [0.93±0.24]); G1: [3.33±0.51]), post-implantation loss (G0: [3.95±1.34], G1: [13.75±3.62]) and reduced fetal viability: [97.30±1.00]; G1: [81.09±6.22]). Regarding fetal formation, the treated group had visceral malformations with a significant frequency: cleft palate (G0: [1.0%], G1: [11.86%]) and reduced kidneys (G0: [0%]; G1: [10.17%]). Regarding skeletal malformations, a higher frequency was observed in the following parameters: incomplete supraoccipital ossification (G0: [0%], G1: [15.25]), absence of ribs (G0: [0%], G1 (G0: [0%], G1 [15.25%]) and absence of one or more of the foot phalanges (G0: [1.0%]; 64%]). CONCLUSION: Results indicate that ESC is an embryotoxic and teratogenic drug. IMPLICATIONS: Until further studies are performed, greater caution is necessary in prescribing the drug to pregnant women.

Knowledge and Practices of Mothers towards Infant Oral Health Care in Their Children's First Year of Life / Conhecimentos e Práticas de Mães Sobre a Saúde Bucal Infantil no Primeiro Ano de Vida de seus Filhos

This study aimed to assess mothers' oral health-related knowledge and practices in immediate and late puerperium, and in the child's first year of life. This study is a prospective cohort study, in which data were collected from 358 mothers of children born between 2013 and 2014, in immediate and late puerperium, and in children's first year of life, by interviews with sociodemographic characterization and oral health questionnaires, and were analyzed by descriptive statistics and Chi-square test (α = 5%). Participants were mainly aged 20 to 29 years (53.9%), with 7 to 11 years of education (67.6%), from low social class (72.3%), unemployed (58.9%), married or in common-law marriage (84.1%), with more than one child (60.1%). Although 51.7% of them had received information about children's oral health, only 0.8%, 32.4% and 13.7%, respectively, knew the concept, etiology and preventive attitudes regarding dental caries. Mothers aged under 20 and over 30 years, with lower education and from low social class presented significantly lower oral health related knowledge. At children's first year of life, although 78.7% of the children had already been taken to the dentist, half of them had already tasted sugary foods and drinks. It is highlighted the social determination and the need of an improvement of mothers' oral health-related knowledge and practices. Educational actions, especially in prenatal programs, are important to achieve this improvement and to decrease early childhood caries rates. (AU)

Avaliar o conhecimento e as práticas de mães sobre a saúde bucal de seus filhos no puerpério imediato, tardio, e no primeiro ano de vida da criança. Trata-se de um estudo de coorte prospectiva, no qual os dados foram coletados de 358 mães de bebês nascidos entre 2013 e 2014, no puerpério imediato, tardio e um ano após o parto, por entrevistas com perguntas sobre dados sociodemográficos e sobre saúde bucal. Os dados foram analisados por estatísticas descritivas e pelo teste Qui-quadrado (α = 5%). As participantes apresentavam, majoritariamente, idades entre 20 a 29 anos (53,9%), com 7 a 11 anos de estudo (67,6%), eram de baixa classe social (72,3%), desempregadas (58,9%), casadas ou em união estável (84,1%), e tinham mais de um filho (60,1%). Apesar de 51.7% delas afirmarem ter recebido informações sobre saúde bucal infantil, apenas 0,8%, 32,4% e 13,7%, respectivamente, sabiam o conceito, etiologia e as atitudes preventivas à cárie. Mães com idades abaixo de 20 e acima de 29 anos apresentaram menor conhecimento sobre saúde bucal do que as demais. No primeiro ano de vida, apesar de 78,7% das crianças já terem ido ao dentista, metade delas já havia experimentado alimentos e bebidas açucarados. Destaca-se a determinação social e a necessidade de melhora no conhecimento e práticas das mães sobre saúde bucal. Ações educativas, especialmente em programas de atenção pré-natal, são importantes para atingir essa melhora e, consequentemente, diminuir as taxas da cárie na primeira infância. (AU)

Folheto educativo melhora o conhecimento de pais frente ao traumatismo alvéolo-dentário? / Do educational leaflets improve the knowledge of parents when faced with traumatic dental injuries?

Objetivo: Este estudo teve como objetivo verificar a eficácia de um folheto educativo para melhoraro nível de conhecimento sobre o pronto-atendimento em casos de traumatismo alvéolo-dentário (TAD) por pais/responsáveis de crianças de até 12 anos. Materiais e Métodos: Uma amostra de 257 pais/responsáveis decrianças de até 12 anos de idade que faziam acompanhamento em Unidades de Saúde do Município de Colombo(PR) entre junho e setembro de 2012 respondeu a questionários com dados demográficos e socioeconômicose sobre atitudes no prontoatendimento de casos de TAD (QTAD). O QTAD é um questionário autoaplicado, composto por 10 perguntas de múltipla escolha referentes a situações de avulsão, intrusão, extrusão e fratura na dentição decídua e permanente e foi aplicado antes (QTAD1) e imediatamente após (QTAD2) a leitura do folheto educativo. O folheto educativo se baseou nas orientações da Sociedade Brasileira de Traumatologia Dentária, continha instruções sobre como proceder diante de casos de TAD e possuía ilustrações coloridas das situações, linguagem simples e direta. Resultados: Após a leitura do folheto, houve aumento no escore total do QTAD (Teste de Wilcoxon, p < 0,001) e na frequência de acertos para a maioria das questões individuais, sendo o aumento mais expressivo para respondentes jovens (rs = -0,127, p = 0,042), com maior escolaridade (Teste de Mann-Whitney, p < 0,001), maior renda (rs = 0,135, p = 0,030) e menor escore em QTAD1 (rs = -0,524, p <0,001). Conclusão: O folheto educativo mostrou-se um instrumento válido para melhorar o conhecimento de pais/responsáveis sobre o pronto-atendimento em casos de TAD em crianças.