Caries and its association with infant feeding and oral health-related behaviours in 3-4-year-old Brazilian children.

OBJECTIVES: To investigate the relationships between socio-demographic factors, infant feeding habits, oral hygiene and the prevalence and patterns of caries in Brazilian 3-4-year-olds. METHODS: Systematic random sampling was used to select children enrolled in municipal nurseries in Araraquara, Brazil, in 1998. Clinical examinations were carried out by one examiner using dmft and dmfs indices and WHO criteria. Questionnaires for information related to the socio-demographic background, oral hygiene and dietary history of the children were completed by their mothers. RESULTS: Caries was seen in 46% of the children; 17% of them had the more extensive pattern involving molars and incisors. Social class, mother's education, and age at which breast-feeding terminated showed statistically significant associations with caries. Feeding bottles with added sugars were still being given to 80% of the children. When the significant variables were taken into account only age at which breast-feeding terminated showed a significant relationship to the pattern of disease. Children who were never breast-fed or were breast-fed beyond the age of 24 months had a higher prevalence of the more extensive pattern of caries. CONCLUSIONS: The association between the length of time a mother breast-feeds and extensive caries should be a consideration in any local infant feeding policies or health promotion strategies. The duration for appropriate breast- or bottle-feeding should be emphasised.

Prevalence of caries and developmental defects of enamel in 9-10 year old children living in areas in Brazil with differing water fluoride histories.

AIMS: To assess the prevalences of caries, of developmental defects of enamel and their interrelationship in Brazilian 9-10-year-olds from areas of contrasting fluoridation histories. METHODS: Systematic random sampling procedures were used to select children from an area where water had been fluoridated in 1963 and from a second area where water had been fluoridated since 1998. Clinical examinations for caries were carried out using the DMFT index and WHO diagnostic criteria. Developmental defects of enamel on upper incisors were diagnosed using the DDE index. RESULTS: A difference of 40% in DMFT was observed, with a lower prevalence of disease in the area fluoridated since 1963. Diffuse opacities affected 14.3% of the children from the area fluoridated since 1963 compared with only 2.4% in the area fluoridated in 1998. Children living in the area fluoridated in 1963 who had diffuse defects had twice the chance of being free from caries compared with those living in the same area who had no defects or who had only demarcated or hypoplastic defects. CONCLUSIONS: This study confirms previous ones in showing the benefits of water fluoridation. Diffuse opacities of upper incisors affected relatively few subjects in either of the two areas.

Prevalence and severity of caries in 3-12-year-old children from three districts with different fluoridation histories in Araraquara, SP, Brazil.

OBJECTIVE: To determine the prevalence and severity of caries in 3-12-year-old children in three districts of the city of Araraquara. DESIGN: An epidemiological survey was carried out by trained and calibrated examiners in 1995 and 1996, using the WHO diagnostic criteria. SETTING: Two districts, Araraquara and Vila Xavier had been fluoridated since 1963 and one, Gavião Peixoto, since 1994. SUBJECTS: The study included 1,191 children from Araraquara, 653 from Vila Xavier and 652 from Gavião Peixoto. OUTCOME MEASURES: Prevalence of caries, dmft, dmfs, DMFT and DMFS indices. RESULTS: Results showed moderate caries experience in all three districts. Differences between districts in relation to fluoridation history were particularly obvious in primary teeth. In 3-4-year-old children, one third of those in Araraquara and Vila Xavier had some caries experience compared to 58% in Gavião Peixoto. In permanent teeth, 20% or less of the mean DMFT was made up of untreated decay in Araraquara and Vila Xavier whereas in Gaviao Peixoto it made up between 50 and 57% of values in 7-12-year-old children. CONCLUSIONS: The prevalence and severity of caries was lower in dentitions of children from the districts fluoridated since 1963. Improvements are likely in the future in Gavião Peixoto as the benefit of fluoridation continues but additional means of promoting oral health are needed in all three districts.

Comparison of two indices of caries patterns in 3-6 year old Brazilian children from areas with different fluoridation histories.

The purpose of this study was to define the pattern of caries in 3-6 year old children from two districts in Araraquara, SP, Brazil, fluoridated for more than 10 years and from a much more recently fluoridated one in the same city, using two different indices. The study included 1,066 children (903 from the two first districts and 163 from the third). Patterns of disease were described in terms of prevalence and dmft in molars, incisors (and/or canines) individually and together. Pattern was also described according to the 'caries analysis system'. In both areas the majority of 3-4 year olds had disease confined to primary molars. In the areas fluoridated for more than 10 years, the highest proportion of 5-6 year olds with caries also had the disease confined to primary molars (36 per cent) but in the more recently fluoridated area, similar proportions of children had caries in primary molars alone as had caries in both primary molars and incisors (40 per cent and 44 per cent, respectively). Results according to the 'caries analysis system' showed that in both areas the prevalence of fissure caries and posterior bucco-lingual surface pattern in 5-6 year olds were twice as great as those observed in 3-4 year olds. Differences between the areas were obvious whichever method was used to define pattern, confirming the benefits of water fluoridation. The simpler method of grouping tooth type affected showed the differences as effectively as the more complex 'caries analysis system'.

An analysis of poison control center reports of ciguatera toxicity in Puerto Rico for one year.

Forty-five cases of ciguatera poisoning in Puerto Rico (P.R.) are described. These cases represent all those reported to the P.R. Poison Control Center in 1982. Most of the cases were reported in the spring and summer months. The most common fish ingested was the grouper. The clinical presentation of acute and long term symptoms was similar to that reported in other geographical areas, except the incidence of paresthesias. Paresthesias were reported in 11% of the patients reported to the poison center. A companion telephone survey indicated that persons in P.R. that do not eat fish do so because of fear of ingesting the toxin. Our findings indicate an overall familial contact with the ciguatera toxin in Puerto Rico at 7%. This study is the first to document that ciguatera is a common poisoning reported to the Poison Control Center in Puerto Rico. Our findings also support other authors contentions of geographical variations in clinical symptomatology.

Progress in antimycotic chemotherapy 1945-1980

Before 1950 no reliable or safe therapy existed for systemic and invasive mycoses, and only traditional and empirical topical preparations were available for dermatomycoses. Two distinct eras of rapid progress in antifungal therapy followed: first, in the 1950's came the introduction of the polyenes, nystatin and pimaricin for cutaneous, vaginal and intestinal candidiasis, and amphotericin B for the treatment of severe systemic mycoses. The second phase saw the successful introduction and clinical use of 5-fluorocytosine and several imidazole derivatives some twenty years later, at a time when the vast increase in iatrogenic systemic mycoses caused by opportunistic fungi had created an urgent and pressing need for new agents in addition to those still effective.